Snoring, Pregnancy-Induced Hypertension, and Growth Retardation of the Fetus*

Franklin, Karl A. MD, PhD, FCCP
Holmgren, Per Åke MD, PhD
Jönsson, Fredrik MD
Poromaa, Nils MD
Stenlund, Hans PhD
Svanborg, Eva MD, PhD

*From the Departments of Respiratory Medicine (Drs. Franklin and Jönsson), Gynecology and Obstetrics (Drs. Holmgren and Poromaa), and Epidemiology and Public Health (Dr. Stenlund), University Hospital, Umeå; and the Department of Clinical Neurophysiology (Dr. Svanborg), Karolinska Hospital, Stockholm, Sweden.

The study was supported by grants from the Swedish Heart and Lung Foundation and the Swedish Association for Heart and Lung Patients.

Manuscript received November 20, 1998; revision accepted August 16, 1999.

Correspondence to: Karl A. Franklin, MD, PhD, FCCP, Department of Respiratory Medicine, University Hospital, SE-901 85 Umeå, Sweden; e-mail: [email protected]

Chest 117(1):p 137-141, January 2000.

Study objective:

Our purpose was to study the relationship between snoring and pregnancy-induced hypertension and growth retardation of the fetus.

Design:

Retrospective, cross-sectional, consecutive case series.

Setting:

The Department of Gynecology and Obstetrics, University Hospital, Umeå, Sweden.

Participants and measurements:

On the day of delivery, 502 women with singleton pregnancies completed a questionnaire about snoring, witnessed sleep apneas, and daytime fatigue. Data concerning medical complications were taken from the women's casebooks.

Results:

During the last week of pregnancy, 23% of the women reported snoring every night. Only 4% reported snoring before becoming pregnant. Hypertension developed in 14% of snoring women, compared with 6% of nonsnorers (p < 0.01). Preeclampsia occurred in 10% of snorers, compared with 4% of nonsnorers (p < 0.05). An Apgar score ≤ 7 was more common in infants born to habitual snorers. Growth retardation of the fetus, defined as small for gestational age at birth, had occurred in 7.1% of the infants of snoring mothers and 2.6% of the remaining infants (p < 0.05). Habitual snoring was independently predictive of hypertension (odds ratio [OR], 2.03; p < 0.05) and growth retardation (OR, 3.45; p < 0.01) in a logistic regression analysis controlling for weight, age, and smoking.

Conclusions:

Snoring is common in pregnancy and is a sign of pregnancy-induced hypertension. Snoring indicates a risk of growth retardation of the fetus.