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Obstructive Sleep apnea (OSA) is a common and underdiagnosed condition in obese pregnant women with serious and life-threatening complications to the mother and baby. The investiators propose that a non-invasive method may be used to detect patients at risk of OSA, giving these women access to the necessary treatment to treat this condition. The method is a estimation of body water, which has been shown to be linked to OSA in the non-pregnant population. Body water is estimated by applying surface electrodes to a participant who is lying down by measuring bioimpedance through body tissues by applying a tiny current between the electrodes. The electrical stimulation is not felt by the participant and has no negative effects on mother or baby.
It is already established that the increasingly prevalent condition of obesity is linked to OSA in pregnancy. Obesity is increasingly prevalent This study will evaluate a novel method of screening for OSA in the obese pregnant population, thereby treating this condition reducing the ill effects to mother and fetus.
This will be a prospective observational cohort study. Eligible participants will be approached for consent during their third-trimester antenatal all-day clinic visit. Body water will be measured by connecting electrodes to participants hands, feet and neck whilst lying supine for approximately 15 minutes.
Data on patient demographics, BMI, medical conditions, water body composition and indicators of OSA (breathing pattern and oxygen levels during sleep) will be collected, as well as data from patients' sleep tests as ordered by their physician.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Total body water measurement | Total body water will be measured using Bioelectrical Impedance Analysis (BIA). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bioelectrical Impedance Analysis (BIA) | Device | BIA will be used to determine total body water |
|
| Measure | Description | Time Frame |
|---|---|---|
| Presence of sleep apnea | The diagnosis of sleep apnea will be made using apnea hypopnea index (AHI). A diagnosis of OSA is present if a person has an AHI ≥5/hour. | 12 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Total body water measurement | Total body water will be measured using Bioelectrical Impedance Analysis (BIA) | Following consent, this measurement will be done, and will take approximately 30 minutes |
| Mallampati score |
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Inclusion Criteria:
Exclusion Criteria:
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Eligible participants will be approached for consent at our high risk maternal and infant program clinic on the day of their regularly scheduled appointment.
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| Name | Affiliation | Role |
|---|---|---|
| Mrinalini Balki, MD | MOUNT SINAI HOSPITAL | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mount Sinai Hospital | Toronto | Ontario | M5G1X5 | Canada |
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The patient is asked to open their mouth wide and stick out their tongue. Upon observation, the view is classified/scored as Class 1-4. Class one would be least likely to have airway problems and 4 most likely.
| Done during initial exam following consent, this exam will take 1-2 minutes |
| Thyromental distance (cm) | The distance between the thyroid notch and the tip of the jaw with the head extended is evaluated. | Done during initial exam following consent, this exam will take 1-2 minutes |
| Subluxation of mandible beyond maxilla | The patient is asked to extend their mandible beyond the top lip if possible. Scoring is yes or no. | Done during initial exam following consent, this exam will take 1-2 minutes |
| Neck extension | The patient is asked to extend their neck, looking upwards and back, as far as comfortably possible. Scoring is yes if movement is possible, no if extension is not possible. | Done during initial exam following consent, this exam will take 1-2 minutes |
| Height (cm) | Height measured in cm to calculate Body Mass index (BMI) | Done during initial exam following consent, this exam will take 1-2 minutes |
| Weight (kg) | Weight measured in kg to calculate Body Mass index (BMI) | Done during initial exam following consent, this exam will take 1-2 minutes |
| Neck size | Circumference around the neck, measured in centimeters. | Done during initial exam following consent, this exam will take 1-2 minutes |
| Questionnaire related to snoring | Patients will be asked if they snore, if others can hear their snoring and if they are bothered by it. Yes or no answers. | Done during initial exam following consent, this exam will take 1-2 minutes |
| Questionnaire related to sleep | Patients will be asked if they wake frequently during sleep, if they wake with a choking sensation, and whether they doze off or fall asleep while sitting/talking. Yes or no answers. | Done during initial exam following consent, this exam will take 1-2 minutes |
| ID | Term |
|---|---|
| D020181 | Sleep Apnea, Obstructive |
| D009765 | Obesity |
| ID | Term |
|---|---|
| D012891 | Sleep Apnea Syndromes |
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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