The effect of continuous positive airway pressure treatment on hypertensive disorder in pregnant women with obstructive sleep apnea.

Purpose: Our study aimed to determine the effect of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) on the incidence and severity of hypertensive syndrome in pregnancy.

Methods: The study included women with high-risk pregnancies and the Epworth Sleepiness Scale score ≥ of 10. Polygraphic testing was done between 18 and 20 weeks. Participants were divided into three groups: pregnant women with OSA starting treatment with CPAP for 4 weeks between 24 and 28 gestational weeks, women with OSA treated conservatively, and women without OSA as the control group. Participants were followed up regularly for 4 weeks until the delivery and 1 week after for the occurrence of hypertensive syndrome and other maternal complications.

Results: Among the 110 women enrolled in the study, the prevalence of hypertensive syndrome in 41 pregnant women with OSA treated conservatively was 39%, 50 women with OSA treated with CPAP 26%, and 19 women in the control group 21%, p = 0.1. The group treated with CPAP when compared with the conservatively treated group had a significantly lower incidence of severe forms of hypertensive syndrome (8% vs. 24%, p = 0.02.), and after 1 month of treatment had higher night oxygen saturation (92%, vs. 87%, p = 0.003) and lower Epworth Sleepiness Scale score (respectively, 4.2 ± 2.3 vs. 9.4 ± 4.1, p < 0001). The respiratory event index was significantly associated with hypertension severity (patients with preeclampsia 9.5 ± 4.9 vs. without hypertension 6.9 ± 4.5, p = 0.04).

Conclusion: CPAP therapy significantly reduced the incidence of severe forms of hypertensive syndrome in pregnant women with OSA.