Introduction Gestational obstructive sleep apnoea (G-OSA) affects around one in four pregnant women,1 and is associated with poor maternal and foetal outcomes.2–4 G-OSA therefore represents a potentially modifiable risk-factor for perinatal outcomes, but more intensive screening risks overdiagnosis due to a lack of research into i) optimal intervention thresholds, and ii) the preferences and experiences service users.5
Method This project aims to explore the perceptions, concerns, and values of service users regarding screening and diagnosis of G-OSA, using qualitative semi-structured interviews with thematic analysis. This study has received research ethics committee approval.
Results At the time of writing interviews are ongoing. Preliminary analysis suggests that, while pregnant women would likely see screening for, or research into G-OSA as being desirable, there are concerns:
Women might not perceive sleep problems as being a risk–factor for adverse outcomes. Increased knowledge of G–OSA would therefore represent an additional perceived ‘risk’ in pregnancy.
Women may feel offended if they felt that their behaviour or lifestyle was a factor in whether screening was offered.
Women may find diagnostic equipment scary and would need reassurance that it would not harm their baby.
Despite the practical burden of screening or treatment for G–OSA, women may feel obliged to take part due to societal pressures.
Women may feel guilty or distressed if they were unable to tolerate continuous positive airway pressure.
Discussion We expect to develop these themes further with more interviews and analysis, but the results so far promise that the research will offer insight into how clinical and research programs might be designed in order to minimise distress and optimise service user participation. This adds to the debate around the risk-benefit analysis of increasing the screening burden faced by women in pregnancy.
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Li L, Zhao K, Hua J, et al. Association between Sleep-Disordered Breathing during Pregnancy and Maternal and Fetal Outcomes: An Updated Systematic Review and Meta-Analysis. Front Neurol 2018;9:91. doi:10.3389/fneur.2018.00091
Brown NT, Turner JM, Kumar S. The intrapartum and perinatal risks of sleep-disordered breathing in pregnancy: a systematic review and metaanalysis. Am J Obstet Gynecol 2018;219:147–161.e1. doi:10.1016/j.ajog.2018.02.004
Bourjeily G, Danilack VA, Bublitz MH, et al. Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort. Sleep Med 2017;38:50–7. doi:10.1016/j.sleep.2017.06.035
Perkins A, Einion A. Pregnant pause: should we screen for sleep disordered breathing in pregnancy?Breathe 2019;15:36–44. doi:10.1183/20734735.0343–2018
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