Oxidative and carbonyl stress in pregnant women with obstructive sleep apnea



Pregnant women are particularly susceptible to sleep-disordered breathing. Obstructive sleep apnea (OSA) in pregnancy is associated with poor pregnancy and fetal outcomes. Oxidative stress caused by intermittent hypoxemia and reoxygenation may impact pregnancy health. We hypothesize that pregnant women with OSA have a pronounced oxidative stress profile.


A case-control study was performed to study oxidative stress markers in the serum of pregnant women with or without OSA. Patients with OSA were identified between 2003 and 2009. Contemporaneous controls were pregnant subjects without apnea, gasping, or snoring around the time of delivery. Serum markers of oxidative and carbonyl stress were measured by spectrophotometric/fluorometric methods. Multiple linear regression analysis was used with a model including age, body mass index at delivery, history of diabetes, and gestational age.


Serum samples from 23 OSA cases and 41 controls were identified. Advanced oxidation protein products, a marker for oxidative stress, and advanced glycation end products (AGEs), a marker for carbonyl stress, were significantly lower in women with OSA than in controls (p value <0.0001). Total antioxidant capacity was higher in women with OSA in comparison to controls (p value <0.0001). The difference in AGEs remained significant even after adjusting for confounders.


Contrary to our hypothesis, the results of this study suggest that pregnant women with OSA have higher antioxidant capacity and lower oxidative and carbonyl stress markers compared to controls, suggesting a possible protective effect of intermittent hypoxia. Whether OSA in pregnancy impacts oxidative stress differently than OSA in the general population remains to be confirmed.

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Corresponding author

Correspondence to Ghada Bourjeily.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants, participation in speakers’ bureaus, membership, employment, consultancies, stock ownership or other equity interest, and expert testimony or patent-licensing arrangements) or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript. GB received research equipment support from Respironics for a federally funded study; however, Respironics had no role in the current study.

Human and animal rights and informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants prospectively recruited into the study. Waiver of consent was obtained for the retrospective component of the study. Both were IRB approved.


GB received funding from NIH R01HL130702 and R01HD078515 and Perkins Charitable Foundation. The Perkins Foundation had no role in study design, conduct, interpretation, or submission of the manuscript.

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Khan, N., Lambert-Messerlian, G., Monteiro, J.F. et al. Oxidative and carbonyl stress in pregnant women with obstructive sleep apnea. Sleep Breath 22, 233–240 (2018). https://doi.org/10.1007/s11325-017-1475-8

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  • Oxidative stress
  • Carbonyl stress
  • Obstructive sleep apnea
  • Sleep-disordered breathing
  • Pregnancy