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Published ahead of print on October 31, 2002, doi:10.1164/rccm.200206-590OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 2, January 2003, 137-140

A more recent version of this article appeared on January 15, 2003
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Submitted on June 21, 2002
Accepted on October 18, 2002

The Upper Airway in Pregnancy and Pre-eclampsia

Bilgay Izci1, Renata L Riha1, Sascha E Martin1, Marjorie Vennelle1, Wang A Liston2, Kirsty C Dundas2, Andrew A Calder2, and Neil J Douglas1*

1 Edinburgh Sleep Centre, The University of Edinburgh, Edinburgh, Scotland, United Kingdom, 2 Dept.of Reproductive and Developmental Sciences, The University of Edinburgh, Edinburgh, Scotland, United Kingdom

* To whom correspondence should be addressed. E-mail: n.j.douglas{at}ed.ac.uk.

Snoring is common in pregnancy and snoring pregnant women have increased rates of pre-eclampsia. Patients with pre-eclampsia show upper airways (UA) narrowing during sleep. The study aimed to compare upper airway dimensions in pregnant and non-pregnant women and in patients with pre-eclampsia. Fifty women in the 3rd trimester of pregnancy and 37 women with pre-eclampsia were recruited consecutively from the antenatal service and matched with 50 non-pregnant women. UA dimensions were measured using acoustic reflection. Comparisons were by analysis of variance and Student-Newman-Keuls tests. 14%of non-pregnant, 28% of pregnant and 75% of pre-eclamptic women reported snoring (p<0.001). Pregnant women had wider upper airways when seated than non-pregnant women (p<0.02) but there was no difference supine. Oropharyngeal junction area (OPJ) in the seated position was narrower (p<0.01) in the pre-eclamptics (0.9sd0.1cm2) than either non-pregnant (1.1sd0.1cm2) or pregnant women (1.3sd0.1cm2). Supine OPJ was narrower in the pre-eclamptic than non-pregnant women (0.8sd0.1, 1.0sd0.1cm2; p=0.01) but similar in pre-eclamptic and pregnant (0.9sd0.1 cm2; p>0.3) women. The study showed that women with pre-eclampsia have upper airway narrowing in both upright and supine postures. These changes could contribute to the upper airways resistance episodes during sleep in patients with pre-eclampsia, which may further increase their blood pressure.
Key words: snoring, pre-eclampsia, sleep




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