Influence of Obstructive Sleep Apnea on Oxidative Stress in Pregnancy

TL;DR

This study found that obstructive sleep apnea in pregnancy does not significantly increase oxidative stress, but apnea duration and hypoxia may still play a role.

Contribution

The study introduces the potential importance of apnea–hypopnea duration and hypoxic burden in understanding OSA's effects on oxidative stress during pregnancy.

Findings

OSA in pregnancy was not associated with increased oxidative stress as measured by protein carbonyl levels.

Shorter apnea–hypopnea events were linked to higher oxidative stress and lower nocturnal oxygen saturation.

Traditional OSA metrics like AHI may not fully capture the relationship between OSA and oxidative stress in pregnancy.

Abstract

Obstructive sleep apnea (OSA) is common during pregnancy and linked to adverse outcomes. While oxidative stress is a proposed pathogenic mechanism, evidence in pregnant populations remains limited. This multicenter, prospective study evaluated oxidative stress through protein carbonyl levels in 171 pregnant women and 86 cord blood samples. Polysomnography (PSG) performed during pregnancy categorized participants with the apnea–hypopnea index (AHI) in OSA, rapid eye movement (REM) OSA, and supine OSA. Protein carbonyl levels were measured by the dinitrophenyl hydrazine (DNPH) method. No significant differences were found in maternal or cord blood protein carbonyl levels between OSA and non-OSA groups, or between REM and supine OSA subgroups. Interestingly, women with shorter apnea–hypopnea (AH) length showed both higher maternal and cord blood protein carbonyl levels and lower nocturnal oxygen saturation. Overall, OSA in pregnancy was not associated with increased oxidative stress as measured by protein carbonyl levels. However, apnea–hypopnea duration and nocturnal hypoxia may influence oxidative stress, pointing to a complex relationship between OSA and oxidative stress during pregnancy, beyond traditional metrics like AHI. Future studies should explore additional biomarkers and diverse molecular pathways that could play a role, with special attention to emerging factors such as apnea–hypopnea length and hypoxic burden to elucidate the interrelationships between OSA and pregnancy more comprehensively.

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