Obstructive Sleep Apnea in Pregnancy: Reliability of Prevalence and Prediction Estimates

OBJECTIVE: We sought to ascertain the validity of two screening scales for obstructive sleep apnea (OSA) in pregnancy and to establish the prevalence of OSA in pregnancy. STUDY DESIGN: In this prospective observational study, two screening scales were administered. Screen positive subjects were referred for diagnostic polysomnography (PSG); if admitted for antepartum care, screen positive subjects underwent a modified study with a type 3 device (T3D). RESULT: 1509 subjects underwent OSA screening; 58 completed diagnostic testing. Neither measure was a reliable diagnostic tool for OSA as determined by T3D or PSG (detection rates of 10.3% and 18.0%, respectively). Among screen positive subjects undergoing PSG or T3D testing, 15.5% ultimately met ‘gold standard’ OSA diagnostic criteria for an estimated point prevalence of 4.9%. CONCLUSION: In this prospective trial, screening positive on the BQ or ESS was poorly predictive of OSA among gravidae and was associated with a high false referral rate.