Original Research|Articles in Press, 100775

Trends in and Outcomes Associated with Obstructive Sleep Apnea during Deliveries in the United States, 2000-2019

Published:February 11, 2023DOI:



      : Population level data on obstructive sleep apnea (OSA) among pregnant women in the United States and associated risk for adverse outcomes during delivery may be of clinical importance and public health significance.


      : To assess trends in and outcomes associated with OSA during delivery hospitalizations.


      : This repeated cross-sectional study analyzed delivery hospitalizations using the National Inpatient Sample. Temporal trends in OSA were analyzed using joinpoint regression to estimate the average annual percent change (AAPC) with 95% confidence intervals (CIs). Survey adjusted logistic regression models were fit to assess the association between OSA and mechanical ventilation or tracheostomy, acute respiratory distress syndrome, hypertensive disorders of pregnancy, peripartum hysterectomy, pulmonary edema/heart failure, stillbirth, and preterm birth.


      : From 2000 to 2019, an estimated 76,753,013 delivery hospitalizations were identified of which 54,238 (0.07%) had a diagnosis of OSA. During the study period, the presence of OSA during delivery hospitalizations increased from 0.4 to 20.5 cases per 10,000 delivery hospitalizations (AAPC 20.6%, 95% CI 19.1%, 22.2%). Clinical factors associated with OSA included obesity (4.3% of women without OSA, 57.7%% of women with OSA), asthma (3.2% of women without OSA, 25.3% of women with OSA), chronic hypertension (2.0% of women without OSA, 24.5% of women with OSA), and pregestational diabetes (0.9% of women without OSA, 10.9% of women with OSA). In adjusted analyses accounting for obesity, other clinical factors, demographics, and hospital characteristics, OSA was associated with increased odds of mechanical ventilation or tracheostomy (aOR 21.9, 95% CI 18.0, 26.7), acute respiratory distress syndrome (aOR 5.9, 95% CI 5.4, 6.5), hypertensive disorders of pregnancy (aOR 1.6, 95% CI 1.6, 1.7), stillbirth (aOR 1.2, 95% 1.0, 1.4), pulmonary edema/heart failure (aOR 3.7, 95% CI 2.9, 4.7), peripartum hysterectomy (aOR 1.66, 95% CI 1.23, 2.23), and preterm birth (aOR 1.2, 95% CI 1.1, 1.2).


      : OSA diagnoses are increasingly common in the obstetric population and are associated with a range of adverse obstetric outcomes during delivery hospitalizations.


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