Perinatal & Pediatric
Maternal early pregnancy body mass index and sleep apnea in the offspring Mia Zhu* Mia Zhu Sven Cnattingius Louise M. O’Brien Eduardo Villamor
Objectives: To investigate the association between maternal early pregnancy body mass index (BMI) and offspring sleep apnea diagnosis.
Methods: We conducted a nationwide cohort study among 3,281,803 singleton live births in Sweden born 1983-2015. Using national registries with prospectively recorded information, we followed participants for a sleep apnea diagnosis from 2 to up to 35 years of age. We compared sleep apnea risks by early pregnancy BMI categories using hazard ratios (HR) with 95% confidence intervals (CI) from adjusted Cox models. We also conducted sibling-controlled analyses among 1,724,473 full siblings.
Results: There were 17,830 sleep apnea diagnoses over a median follow-up age of 17.9 years. Maternal early pregnancy BMI was positively associated with offspring sleep apnea risk; compared with women with normal BMI (18.5-24.9), adjusted HR (95% CI) of offspring sleep apnea for maternal BMI categories overweight (BMI 25.0-29.9), obesity class I (BMI 30.0-34.9), and obesity classes II or III (BMI ≥35.0) were, respectively, 1.14 (1.09, 1.19), 1.28 (1.20, 1.36), and 1.40 (1.27, 1.54). Corresponding HR (95% CI) in sibling comparisons were, respectively, 1.13 (1.01, 1.26), 1.17 (0.97, 1.42), and 1.32 (0.97, 1.80). Pregnancy, birth, and neonatal complications were associated with risk of sleep apnea in offspring, but did not substantially mediate the association between maternal obesity and offspring sleep apnea.
Conclusions: Maternal overweight and obesity are associated with offspring sleep apnea risk in a dose-response manner.