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| Name | Class |
|---|---|
| Johns Hopkins University | OTHER |
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Women at altitude have an increased incidence of pre-eclampsia. Populations at altitude have a greater incidence of sleep apnea. And women with sleep apnea are at increased risk of developing preeclampsia. This research project will recruit for home sleep testing: healthy pregnant women at altitude (Summit County , Colorado at 9000 ft.), and women with preeclampsia at altitude, in order to learn whether either sleep apnea or nocturnal hypoxemia is more common or more severe in women with preeclampsia, than in healthy women at altitude. In addition a healthy co-hort of pregnant women will be studied at sea level, to compare to the healthy cohort of pregnant woman in Summit County, to learn to degree that this difference in altitude effects the severity of sleep apnea and hypoxemia.
It is known that high altitude increases the risk of preeclampsia and small for gestational age births. Our questions are: 1). Is sleep apnea during pregnancy more common and/or more severe at altitude? And 2) Do the women who develop preeclampsia at altitude have more severe sleep apnea, or worse hypoxemia during sleep, than the women at altitude who do not develop preeclampsia. We will perform WatchPAT-one home sleep tests (PAT = peripheral arterial tonometry) on up to 20 pregnant women in Summit County Colorado (>9000 ft.elevation) who develop preeclampsia during pregnancy (soon after diagnosis), and also on up to 20 pregnant healthy women in Summit County, and 20 healthy pregnant women in Baltimore (at sea level). These healthy pregnant women in Summit County and Baltimore will be selected from volunteer participants, to best match age, pre-pregnancy BMI, and race with individuals in Summit County who are studied with preeclampsia and they will be studied at the gestational timing that matches their Summit County preeclampsia matching subject. In addition to the up to 20 healthy pregnant subjects at Summit County and 20 in Baltimore, who match the preeclampsia subjects, we will recruit up to 20 more in Summit County and 20 more in Baltimore, to study specifically in the 33rd or 34th gestational week, to improve our ability to evaluate the effects of altitude on sleep apnea, during pregnancy. Information on the births, including height and weight and apgar scores will be assessed, in part to see whether sleep apnea during pregnancy affects outcomes. All sleep studies will be scored at the JHH (Johns Hopkins Hospital) Bayview sleep lab's Center for Interdisciplinary Sleep Research and Education.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| pregnant with pre-eclampsia at altitude (Cohort 1) | Pregnant women at High Country Obstetric Clinic in Summit County Colorado (about 9000 ft.) who develop pre-eclampsia. Home sleep testing with Watch PAT-one will be done soon after diagnosis of pre-eclampsia. Up to 20 in this cohort |
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| healthy pregnant women at altitude (Cohort 2) | Pregnant healthy women at High Country Obstetric Clinc in Summit County Colorado will also be studied with the Watch PAT-one home sleep test.. Up to 20 will be chosen to match the subjects, 1 by 1, in cohort 1, regarding gestational time of the home sleep test, and match age, pre-pregnant BMI, and race as best as available of the volunteered subjects. Up to another 20 pregnant healthy women at altitude may be recruited, not matching a subject in cohort 1, to have Watch PAT-one home sleep testing in the 33rd to 34th week of pregnancy. |
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| healthy pregnant women at sea level (Cohort 3) | Up to 40 healthy pregnant women at sea level, in vicinity of Baltimore, will be recruited to have Watch PAT-one home sleep testing, matching the subjects in cohort 2 regarding gestational time of testing, Race, Age and pre-pregnant BMI as best as available. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Home Sleep Test with Watch PAT-one | Diagnostic Test | Each participant will have a Watch-PAT one home sleep test, recording pulse oximetry, pulse tonometry, wrist actigraphy, snoring (by microphone), and chest motion by accelerometer. |
| Measure | Description | Time Frame |
|---|---|---|
| Apnea-Hypopnea index 4% | number of apneas and hypopneas dropping oxygen saturation 4%, per hour | in a single full night recording |
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| Measure | Description | Time Frame |
|---|---|---|
| Apnea-Hypopnea Index 3% | number of apneas and hypopneas dropping oxygen saturation 3%, per hour | in a single full night recording |
| Central Apnea-Hypopnea Index 4% | number of central apnea or hypopnea events dropping oxygen saturation 4%, per hour |
Inclusion Criteria: pregnant, age 18-35, possession of, or availablitiy of using a cell phone.
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Exclusion Criteria: for the control group the following are exclusion criteria: hypertension, known sleep apnea, asthma requiring daily inhaler use, other lung disease, diabetes
For the group who are recruited at the time of diagnosis of pre-eclampsia - hypertension is not an exclusion criteria.
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pregnant women, age 15-35, some who are healthy, and some who have developed preeclampsia.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| DAVID S PATZ, MD | Contact | 9706407240 | david.patz@cuanschutz.edu |
| Name | Affiliation | Role |
|---|---|---|
| Cynthia Argani, MD | Johns Hopkins Hospital OB-GYN | Study Chair |
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The data will likely be shared. The precise mechanism of sharing the data is not yet determined.
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| ID | Term |
|---|---|
| D011225 | Pre-Eclampsia |
| D012891 | Sleep Apnea Syndromes |
| ID | Term |
|---|---|
| D046110 | Hypertension, Pregnancy-Induced |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| in a single full night recording |
| Central Apnea Hypopnea Index 3% | number of centrap apnea or hypopnea events dropping oxygen saturation 3%, per hour | in a single full night recording |
| Mean Oxygen Saturation during sleep | the average oxygen saturation | averaged through one full night recording |
| Lowest oxygen saturation during sleep | the single lowest oxygen saturation measured | during one full night recording |
| Time (in minutes) with oxygen saturation below 89% | as above | during one full night recording |
| Time (in minutes) with oxygen saturation below 85% | as above | during one full night recording |
| percentage of babies small for gestational age | length weight and gestational age will be considered for each baby, to determine if it is small for gestational age. comparison will be made between cohorts. But also, analysis to determine is AHI correlated with "small for gestational age" | measurements made at birth. Correlations will be determined at completion of research study |
| Apgar at 1 minute | This will be looked at for correlation with the AHI, along with the usual comparison between cohorts | Measurement, 1 minute after birth. Correlations will be determined at completion of research study. |
| Apgar at 5 minutes | This will be looked at for correlation with the AHI, along with the usual comparison between cohorts. | Measurement, 5 minutes after birth. Correlations will be determined at completion of research study |
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |