Patients and procedures
obesity, hypopneas, chronic infection, cardiac or kidney disease, oxygen desaturation, OSA, hypertension, preeclampsia
OBESITY, CHRONIC INFECTION, THYROID DISEASE, HIV INFECTION, TUBERCULOSIS, NEUROMUSCULAR DISEASE, GESTATIONAL HYPERTENSION, SLEEP; APNEA, HYPERTENSION, PREECLAMPSIA
Pregnant women attending antenatal care at all collaborating hospitals were recruited for OSA screening if they met all of the following inclusion criteria: (1) singleton high-risk pregnant woman aged > 18 years without significant medical conditions (separate from those used as inclusion criteria), including immunocompromised status, chronic infection (HIV infection, or tuberculosis), chronic lung, cardiac or kidney disease, thyroid disease, or neuromuscular disease; (2) gestational age (GA) < 16 weeks for 1st-trimester, or GA 24–28 weeks for 2nd trimester; and (3) Thai nationality, proficient in Thai language. High-risk pregnancy was defined as any of the following: (a) chronic hypertension defined by preexisting-hypertension or hypertension diagnosed before 20 weeks’ gestation; (b) history of preeclampsia or gestational hypertension in the previous pregnancy; (c) obesity defined by pre-pregnancy body mass index (BMI) ≥ 27.5 kg/mSleep stages and respiratory scorings were performed according to the American Academy of Sleep Medicine (AASM) 2012 guidelines [RDI was defined as a number of apneas, hypopneas, and RERA per hour of sleep; apnea–hypopnea index (AHI) was calculated as a number of apneas and hypopneas per hour of sleep [Exclusion criteria included: (1) severe OSA (RDI ≥ 30 events/hour) or significant oxygen desaturation < 80% during sleep; or (2) known OSA currently on CPAP treatment. For ethical reasons, CPAP treatment was offered to severe cases due to potential harms to the mother and fetus and the possible benefit of treatment.