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Sleep Disordered Breathing, a Novel, Modifiable Risk Factor for Hypertensive Disorders of Pregnancy

  • Preeclampsia (VD Garovic, Section Editor)
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Abstract

Purpose of Review

Pathophysiology of hypertensive disorders of pregnancy (HDP), especially preeclampsia, has not been fully elucidated. Most trials aimed at the prevention of preeclampsia have failed to show significant benefit and investigation of novel, modifiable risk factors is sorely needed. Sleep disordered breathing (SDB), a group of disorders for which treatments are available, meets these criteria. SDB impacts about a third of all pregnancies and is associated with hypertension in the general non-pregnant population.

Recent Findings

Recent studies have shown a high prevalence of SDB, especially in complicated pregnancies. Several studies have shown that pregnant women with SDB have a higher risk for developing HDP, and these two disorders are associated with similar maternal long-term cardiovascular outcomes. Based on limited animal models of gestational intermittent hypoxia and human studies, SDB and HDP share similar risk factors and some pathophysiological mechanisms. However, there is paucity of studies addressing causality of this association and identifying therapeutic targets for intervention.

Summary

Maternal SDB represents a novel and modifiable risk factor of HDP. Further studies are needed in order to establish the exact mechanisms underlying this association and to identify specific areas for clinical interventions.

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Acknowledgments

We would like to thank Ms. Beth Hott for her assistance in preparing the manuscript for submission.

Funding

GB is funded by National Heart, Lung, and Blood Institute R01HL130702 and National Institute of Child Health and Human Development R01HD078515 of the National Institutes of Health. MHB is funded by P20 GM103652 from the National Institute of General Medical Sciences, National Institutes of Health.

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Authors and Affiliations

  1. Women’s Medicine Collaborative-Division of Research, The Miriam Hospital, Providence, RI, USA

    Laura Sanapo, Margaret H. Bublitz & Ghada Bourjeily

  2. Departments of Medicine and Psychiatry and Human Behavior, The Miriam Hospital, Providence, RI, USA

    Margaret H. Bublitz

  3. Warren Alpert Medical School of Brown University, Providence, RI, USA

    Margaret H. Bublitz & Ghada Bourjeily

  4. Department of Medicine, The Miriam Hospital, Providence, RI, USA

    Margaret H. Bublitz & Ghada Bourjeily

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  1. Laura Sanapo
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  2. Margaret H. Bublitz
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Correspondence to Ghada Bourjeily.

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Sanapo, L., Bublitz, M.H. & Bourjeily, G. Sleep Disordered Breathing, a Novel, Modifiable Risk Factor for Hypertensive Disorders of Pregnancy. Curr Hypertens Rep 22, 28 (2020). https://doi.org/10.1007/s11906-020-1035-7

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