Continuous positive airway pressure safe in pregnant women

ORLANDO, Fla. — Continuous positive airway pressure use for 2 or more weeks during the third trimester in pregnant women with diet-controlled gestational diabetes and obstructive sleep apnea decreased the risk for preterm delivery and unplanned cesarean section, according to study findings presented here.

Sirimon Reutrakul, MD, associate professor at Mahidol University Faculty of Medicine in Bangkok, evaluated 82 pregnant women with obesity and diet-controlled gestational diabetes to determine the effect of continuous positive airway pressure (CPAP) on obstructive sleep apnea (OSA).

An overnight home monitor was used to screen for OSA and 43 participants were diagnosed with the condition. Participants with OSA were randomized to receive CPAP (n = 28) for 2 weeks or be wait-list controls (n = 15). After the 2 weeks of CPAP treatment all participants were offered the treatment until delivery.

Overall, pregnancy outcomes were available in 38 participants without OSA, 28 with OSA treated with CPAP and 11 with OSA but not treated with CPAP.

No significant differences among the three groups were found for age, prepregnancy BMI or pregnancy outcomes, including subsequent rates of insulin use, preterm delivery (before 37 weeks), preeclampsia, unplanned cesarean section, birth weight, Apgar score at 1 and 5 minutes or rates for small or large for gestational age.

Gestational age did not differ between participants with OSA who did and did not use CPAP.

The risk for preterm delivery was significantly lower in participants with OSA who used CPAP for 2 or more weeks compared with participants without OSA (P = .017) as well as the risk for unplanned cesarean section (P = .026).

“In this study of pregnant women with diet-controlled gestational diabetes and OSA, we found that therapy with CPAP treatment for more than 2 weeks in the third trimester was associated with lower rate of preterm delivery, unplanned cesarean section and newborn admission to the neonatal ICU and special care nursery,” Reutrakul told Endocrine Today. “However, these findings need to be interpreted with caution as the number of women in the study was relatively small, and these outcomes were observed without randomization of treatment.” – by Amber Cox

Reference:

Wanitcharoenkul E, et al. OR11-4. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2017; Orlando, Fla.

Disclosure : Reukatral reports various financial ties with Medtronic, Merck Sharp and Dohme, Novo Nordisk and Sanofi Aventis.