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Epworth Sleepiness Xcale scores and adverse pregnancy outcomes

Show simple item record Bourjeily G. El Sabbagh R. Sawan P. Raker C. Wang C. Hott B. Louis M.
dc.contributor.editor 2013 2017-10-05T15:40:10Z 2017-10-05T15:40:10Z 2013
dc.identifier 10.1007/s11325-013-0820-9
dc.identifier.issn 15209512
dc.description.abstract Purpose: Snoring is associated with adverse pregnancy outcomes including gestational hypertensive disorders, gestational diabetes, and Cesarean deliveries. The purpose of this study was to assess whether excessive daytime sleepiness (EDS) assessed by Epworth Sleepiness Scale (ESS) increases the risk of these complications further. Methods: Following institutional review board approval and informed consent, English-speaking women in the immediate postpartum period were systematically selected and recruited. Women answered a survey that included questions regarding symptoms of sleep-disordered breathing (SDB) using the multivariable apnea prediction index and excessive daytime sleepiness using ESS. Pregnancy and fetal outcomes were collected by review of medical records. Standard statistical analysis with multivariable logistic regression was performed. ESS was evaluated both as a continuous variable and with various cutoffs given that pregnant women are likely more sleepy at baseline than the general population. Results: In patients who underwent planned Cesarean delivery, mean ESS was significantly higher than in those with uncomplicated vaginal delivery, even after adjusting for confounders (adjusted odds ratio (aOR), 1.08; 95 percent CI, 1.01-1.15; p = 0.02). There was no significant association between EDS (defined as ESS of 10) and gestational diabetes or gestational hypertensive disorders in snorers or non snorers. However, a significant association with gestational diabetes was found in patients with an ESS of 16 compared to those with an ESS of ≤16, even after multiple adjustments (aOR, 6.82; 95 percent CI, 1.19-39.27), but the number of subjects in an ESS of 16 category was small. Conclusions: There is an increased association between women with higher ESS and planned Cesarean delivery. Severe EDS was associated with gestational diabetes in pregnant women in a small sample size. Future studies in larger samples need to confirm the association of severe EDS and gestational diabetes and elucidate potential mechanisms of the links with adverse outcomes. © 2013 Springer-Verlag Berlin Heidelberg.
dc.format.extent Pages: (1179-1186)
dc.language English
dc.publisher HEIDELBERG
dc.relation.ispartof Publication Name: Sleep and Breathing; Publication Year: 2013; Volume: 17; no. 4; Pages: (1179-1186);
dc.source Scopus
dc.title Epworth Sleepiness Xcale scores and adverse pregnancy outcomes
dc.type Article
dc.contributor.affiliation Bourjeily, G., Department of Medicine, Brown University, Miriam Hospital, Providence, RI, United States, Women's Medicine Collaborative of Lifespan, Miriam Hospital, 146 West River Street, Providence, RI 02904, United States
dc.contributor.affiliation El Sabbagh, R., Internal Medicine Residency Program, Lebanese University, Beirut, Lebanon
dc.contributor.affiliation Sawan, P., Radiology Residency Program, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Raker, C., Division of Research, Women and Infants Hospital of Rhode Island, Providence, RI, United States
dc.contributor.affiliation Wang, C., Pulmonary and Critical Care Fellowship Program, Warren Alpert Medical School, Brown University, Providence, RI, United States
dc.contributor.affiliation Hott, B., Miriam Hospital, Women's Medicine Collaborative, Providence, RI, United States
dc.contributor.affiliation Louis, M., Department of Medicine, Brown University, Rhode Island Hospital, Providence, RI, United States
dc.contributor.authorAddress Bourjeily, G.; Department of Medicine, Brown University, Miriam Hospital, Providence, RI, United States; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine; Division: Pulmonary and Critical Care Medicine;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision Pulmonary and Critical Care Medicine
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Bourjeily, G
dc.contributor.authorInitials El Sabbagh, R
dc.contributor.authorInitials Sawan, P
dc.contributor.authorInitials Raker, C
dc.contributor.authorInitials Wang, C
dc.contributor.authorInitials Hott, B
dc.contributor.authorInitials Louis, M
dc.contributor.authorReprintAddress Bourjeily, G (reprint author), Miriam Hosp, Womens Med Collaborat Lifespan, 146 West River St,Suite 11C, Providence, RI 02904 USA.
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 8
dc.description.citedTotWOSCount 7
dc.description.citedWOSCount 7
dc.format.extentCount 8
dc.identifier.coden SBLRB
dc.identifier.scopusID 84888646206
dc.publisher.address TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
dc.relation.ispartOfISOAbbr Sleep Breath.
dc.relation.ispartOfIssue 4
dc.relation.ispartofPubTitle Sleep and Breathing
dc.relation.ispartofPubTitleAbbr Sleep Breathing
dc.relation.ispartOfVolume 17
dc.source.ID WOS:000326928000010
dc.type.publication Journal
dc.subject.otherAuthKeyword Cesarean
dc.subject.otherAuthKeyword Daytime sleepiness
dc.subject.otherAuthKeyword Gestational diabetes
dc.subject.otherAuthKeyword Preeclampsia
dc.subject.otherAuthKeyword Pregnancy
dc.subject.otherAuthKeyword Sleep
dc.subject.otherAuthKeyword Sleep-disordered breathing
dc.subject.otherIndex adult
dc.subject.otherIndex apnea
dc.subject.otherIndex article
dc.subject.otherIndex cesarean section
dc.subject.otherIndex daytime somnolence
dc.subject.otherIndex disease association
dc.subject.otherIndex Epworth sleepiness scale
dc.subject.otherIndex female
dc.subject.otherIndex fetus outcome
dc.subject.otherIndex hospital patient
dc.subject.otherIndex human
dc.subject.otherIndex informed consent
dc.subject.otherIndex institutional review
dc.subject.otherIndex major clinical study
dc.subject.otherIndex maternal hypertension
dc.subject.otherIndex medical record review
dc.subject.otherIndex pregnancy diabetes mellitus
dc.subject.otherIndex pregnancy outcome
dc.subject.otherIndex pregnant woman
dc.subject.otherIndex priority journal
dc.subject.otherIndex puerperium
dc.subject.otherIndex sleep disordered breathing
dc.subject.otherIndex vaginal delivery
dc.subject.otherKeywordPlus FETAL-GROWTH RESTRICTION
dc.subject.otherKeywordPlus DAYTIME SLEEPINESS
dc.subject.otherKeywordPlus INDUCED HYPERTENSION
dc.subject.otherKeywordPlus GESTATIONAL HYPERTENSION
dc.subject.otherKeywordPlus HEART HEALTH
dc.subject.otherKeywordPlus RISK-FACTORS
dc.subject.otherKeywordPlus APNEA
dc.subject.otherKeywordPlus ASSOCIATION
dc.subject.otherKeywordPlus POPULATION
dc.subject.otherKeywordPlus WOMEN
dc.subject.otherWOS Clinical Neurology
dc.subject.otherWOS Respiratory System

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