Predicting Perinatal Outcomes With an Obstructive Sleep Apnea Screening Tool [13N]. (May 2017) - Bracero, Luis A.
Abstract : INTRODUCTION: The objective was to determine if a screening tool for obstructive sleep apnea (OSA) can be used to predict adverse perinatal outcomes. METHODS: Prospective observational study of patients receiving prenatal care (June 1 2013-May 31 2014) at a tertiary care center clinic. Patients were universally screened for OSA with the STOP questionnaire, a concise tool with four questions related to snoring, tiredness during daytime, observed apnea, and high blood pressure. It has been validated in surgery patients. Positive and negative screens and several confounding variables were included in a backwards logistic regression model to predict the following adverse perinatal outcomes: cesarean delivery, preeclampsia, preterm delivery (PTD) (<37 weeks), low birth weight (LBW) (<2500 g), Intra Uterine Growth Restriction, and Neonatal Intensive Care Unit (NICU) admission. RESULTS: Of the 680 patients who received prenatal care, 442 (65%) had singleton births and were included in analysis. Patient body mass indexes ranged from 12.8-61.4 with mean of 29.7. This study population had high tobacco (241; 54.5%) and illicit drug use (155; 35.1%). Positive STOP screens (64;14.5%) were associated with two outcomes: PTD and NICU admission. For PTD, history of pre-term labor was the strongest predictor, followed by STOP and nulliparity with odds ratios (OR) of 4.2 (95% CI 2.0-8.8; p < 0.001), 2.8 (95% CI 1.4-5.8; p=0.004), and 2.3 (95% CI 1.2-4.4; p=0.013). For NICU admission, a positive STOP was the only significant predictor with 2.5 OR (95% CI 1.1-5.7; p=0.036). CONCLUSION: The STOP screening questionnaire may be useful in predicting PTD and NICU admission.