Racial/ethnic disparities in sleep‐disordered breathing during pregnancy in the nuMoM2b study

Author:

Lucchini Maristella1ORCID,Rayport Yael1,Valeri Linda2,Jelic Sanja3,St‐Onge Marie‐Pierre4ORCID,O'Brien Louise M.56,Alcantara Carmela7

Affiliation:

1. Department of Psychiatry Columbia University Irving Medical Center New York New York USA

2. Department of Biostatistics Columbia University Mailman School of Public Health New York New York USA

3. Division of Pulmonary, Allergy and Critical Care Medicine Columbia University Irving Medical Center New York New York USA

4. Division of General Medicine and Sleep Center of Excellence, Department of Medicine Columbia University Irving Medical Center New York New York USA

5. Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology Michigan Medicine Ann Arbor Michigan USA

6. Division of Sleep Medicine, Department of Neurology Michigan Medicine Ann Arbor Michigan USA

7. School of Social Work Columbia University New York New York USA

Abstract

AbstractObjectiveThe aim of this study was to assess the prevalence and severity of sleep‐disordered breathing (SDB) across racial/ethnic groups in 3702 pregnant people at 6 to 15 and 22 to 31 weeks gestational age, examine whether BMI modifies the association between race/ethnicity and SDB, and investigate whether interventions to reduce weight might reduce racial/ethnic disparities in SDB.MethodsDifferences by race/ethnicity in SDB prevalence and severity were quantified via linear, logistic, or quasi‐Poisson regression. Controlled direct effect was used to estimate whether intervening on BMI would remove/diminish differences by race/ethnicity in SDB severity.ResultsThis study comprised 61.2% non‐Hispanic White (nHW), 11.9% non‐Hispanic Black (nHB), 18.5% Hispanic, and 3.7% Asian people. SDB prevalence was higher for nHB compared with nHW pregnant people at 6 to 15 weeks (odds ratio [OR] 1.81, 95% CI [1.07, 2.97]), whereas at 21 to 32 weeks, Asian pregnant people had a higher SDB prevalence than nHW (OR 2.2, 95% CI [1.1, 4.0]). The severity of SDB differed across racial/ethnic groups in early pregnancy, with nHB pregnant people having a higher apnea‐hypopnea index (AHI) (OR 1.35, 95% CI [1.07, 1.69]) compared with nHW. Having overweight/obesity was associated with a higher AHI (β = 2.36, 95% CI [1.97, 2.84]). Controlled direct effect analyses indicated that in early pregnancy, nHB and Hispanic pregnant people would have a lower AHI compared with nHW people had they had normal weight.ConclusionsThis study extends knowledge on racial/ethnic disparities in SDB to a pregnant population.

Funder

American Academy of Sleep Medicine Foundation

National Heart, Lung, and Blood Institute

Agency for Healthcare Research and Quality

Publisher

Wiley

Subject

Nutrition and Dietetics,Endocrinology,Endocrinology, Diabetes and Metabolism,Medicine (miscellaneous)

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