0897 Maternal Body Mass Index, Pregnancy-onset Snoring and Hypertensive Disorders of Pregnancy; Potential Pathways of Associations. (27th April 2018)

• Record Type: Journal Article
• Authors: Dunietz, G L; Shedden, K; Lisabeth, L D; Treadwell, M C; O'Brien, L M
• Is Part Of: Sleep. Volume 41(2018)Supplement 1
• Page Start: A333
• Page End: A333
• Publication Date: 2018-04-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy061.896
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Hypertensive disorders of pregnancy (HDP) are linked to maternal body mass index (BMI) and frequent snoring. However, pathways of associations between maternal BMI, pregnancy-onset snoring and HDP were only partially estimated. We examined and quantified the total and direct associations between pre-pregnancy BMI and incident HDP and their indirect pathway through pregnancy-onset snoring. Methods: Third trimester pregnant women, without pre-pregnancy hypertension and/or snoring enrolled into this study from prenatal clinics of a large tertiary medical center. Sleep data were collected through a questionnaire. Demographic and pregnancy information was abstracted from medical charts. We used causal mediation analysis to estimate the direct association between pre-pregnancy maternal BMI and HDP, their indirect association through pregnancy-onset snoring, and their total association. The proportion of direct and indirect associations from the total association of pre-pregnancy BMI and HDP was also quantified. Results: A total of 1, 625 pregnant women enrolled into the study, of which we excluded 169 and 123 women with chronic hypertension and/or chronic snoring, respectively. Maternal pre-pregnancy BMI was directly associated with a 1.4-fold incident HDP, adjusted for maternal characteristics. Pregnancy-onset snoring significantly mediated the association of pre-pregnancy BMI and incident HDP: adjusted OR=1.07 (95% CI 1.01, 1.14). The mediated pathway of pre-pregnancy BMI and incident HDP by pregnancy-onset snoring accounted for 16% of the total association for pre-pregnancy BMI. Conclusion: Pregnancy-onset snoring mediates the association between pre-pregnancy maternal BMI and incident HDP in women without pre-pregnancy snoring or hypertension. These findings demonstrate the relative contribution of pre-pregnancy BMI and pregnancy-onset snoring to incident HDP. Identification of these two pathways to incident HDP may have prenatal care implications for at-risk pregnant women. Support (If Any): This work was supported by a T32 Grant from the National Institute of Neurological Disorders and Stroke (NIH/NINDS T32 NS007222); by an F32 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH/NICHD F32 HD091938); by the National Heart, Lung, and Blood Institute (R21 HL089918) and (K23 HL095739) and in part by R21 HL087819.