Association of obstructive sleep apnea with adverse pregnancy-related outcomes in military hospitals. Spence D.L., Allen R.C., Lutgendorf M.A., Gary V.R., Richard J.D., & Gonzalez S.C. 2017.
Association of obstructive sleep apnea with adverse pregnancy-related outcomes in military hospitals [link]Paper  abstract   bibtex   
Background Obstructive sleep apnea (OSA) is associated with significant morbidity and mortality in non-obstetrical and obstetrical patients. Objectives To estimate the prevalence of OSA and its relationship with pregnancy-related complications in a general obstetric population of Department of Defense beneficiaries receiving direct-care at military treatment facilities. Study design A retrospective cohort study of all women (N = 305,001) who gave birth at a military treatment facility from 2008 to 2014. OSA cases were randomly selected and matched on age (3:1 ratio) to non OSA cases. Multivariable logistic regression was used to examine the risks of adverse pregnancy outcomes (cesarean delivery, gestational diabetes, gestational hypertension, preeclampsia, postoperative wound complications, hospital stay greater than five days, acute renal failure, pulmonary edema, preterm delivery, poor fetal growth, and stillbirth) between pregnant women with and without a diagnosis of OSA. Cases were identified using ICD-9 codes, while controlling for demographics, obesity, and medical comorbidities associated with OSA and the outcomes of interest. Results We identified 266 cases of OSA (OSA rate = 8.7 per 10,000; increased from 6.4 to 9.9 per 10,000 from 2009 to 2013). OSA was associated with a higher odds of cesarean delivery (AOR,1.60; 95% CI, 1.06-2.40), gestational hypertension, (AOR, 2.46; 95% CI, 1.30-4.68), preeclampsia (AOR, 2.42; 95% CI, 1.43-4.09), and preterm delivery (AOR, 1.90; 95% CI, 1.09-3.30). Conclusions Obstructive sleep apnea is associated with adverse maternal and fetal outcomes. Copyright © 2016
@misc{spence_d.l._association_2017,
	title = {Association of obstructive sleep apnea with adverse pregnancy-related outcomes in military hospitals},
	url = {http://www.elsevier.com/locate/ejogrb},
	abstract = {Background Obstructive sleep apnea (OSA) is associated with significant morbidity and mortality in non-obstetrical and obstetrical patients. Objectives To estimate the prevalence of OSA and its relationship with pregnancy-related complications in a general obstetric population of Department of Defense beneficiaries receiving direct-care at military treatment facilities. Study design A retrospective cohort study of all women (N = 305,001) who gave birth at a military treatment facility from 2008 to 2014. OSA cases were randomly selected and matched on age (3:1 ratio) to non OSA cases. Multivariable logistic regression was used to examine the risks of adverse pregnancy outcomes (cesarean delivery, gestational diabetes, gestational hypertension, preeclampsia, postoperative wound complications, hospital stay greater than five days, acute renal failure, pulmonary edema, preterm delivery, poor fetal growth, and stillbirth) between pregnant women with and without a diagnosis of OSA. Cases were identified using ICD-9 codes, while controlling for demographics, obesity, and medical comorbidities associated with OSA and the outcomes of interest. Results We identified 266 cases of OSA (OSA rate = 8.7 per 10,000; increased from 6.4 to 9.9 per 10,000 from 2009 to 2013). OSA was associated with a higher odds of cesarean delivery (AOR,1.60; 95\% CI, 1.06-2.40), gestational hypertension, (AOR, 2.46; 95\% CI, 1.30-4.68), preeclampsia (AOR, 2.42; 95\% CI, 1.43-4.09), and preterm delivery (AOR, 1.90; 95\% CI, 1.09-3.30). Conclusions Obstructive sleep apnea is associated with adverse maternal and fetal outcomes. Copyright © 2016},
	journal = {European Journal of Obstetrics Gynecology and Reproductive Biology},
	author = {{Spence D.L.} and {Allen R.C.} and {Lutgendorf M.A.} and {Gary V.R.} and {Richard J.D.} and {Gonzalez S.C.}},
	year = {2017},
	keywords = {*apnea monitoring, *army, *hospitalization, *maternal hypertension, *pregnancy complication/di [Diagnosis], *pregnancy outcome, *sleep disordered breathing, *sleep disordered breathing/di [Diagnosis], ICD-9, acute kidney failure, adult, article, cesarean section, chronic disease, cohort analysis, comorbidity, comparative study, controlled clinical trial, controlled study, diagnosis, female, fetus, fetus growth, fetus outcome, hospital charge, hospital mortality, human, hypertension, logistic regression analysis, lung edema, major clinical study, maternal hypertension/di [Diagnosis], obesity, obesity/di [Diagnosis], preeclampsia, preeclampsia/di [Diagnosis], pregnancy diabetes mellitus, pregnancy outcome, pregnant woman, premature labor/di [Diagnosis], prematurity, prevalence, priority journal, public hospital, randomized controlled trial, retrospective study, stillbirth, surgery, wound complication}
}

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