[Comparative analysis of maternal and neonatal outcomes in women with obstructive sleep apnea hypopnea syndrome of different severity levels during pregnancy].

<b>Objective:</b> To analyze the maternal and neonatal outcomes of obstructive sleep apnea hypopnea syndrome (OSAHS) during pregnancy with different severity levels. <b>Methods:</b> Pregnant women who visited the obstetrics outpatient clinic at Peking University People's Hospital with suspected OSAHS symptoms such as nocturnal snoring from January 2021 to May 2024 and completed home sleep apnea monitoring (HSAT) were retrospectively included. Based on the apnea-hypopnea index (AHI), participants were divided into three groups, the non-OSAHS group (AHI<5/h), mild OSAHS group (5/h≤AHI<15/h), and moderate-to-severe OSAHS group (AHI≥15/h). Differences in maternal and neonatal outcomes were compared including hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), gestational age at delivery, neonatal birth weight, Apgar score, and the ratio of placental weight to birth weight among the three groups. <b>Results:</b> A total of 506 pregnant women, aged (33.7±4.3) years were included in the analysis, with 268 in the non-OSAHS group, 188 in the mild OSAHS group, and 50 in the moderate-to-severe OSAHS group. Statistically significant differences were observed among the three groups in pre-pregnancy and pregnancy body mass index (BMI), neck circumference, pregestational diabetes mellitus (PGDM), minimum percutaneous oxygen saturation, AHI, and oxygen desaturation index (ODI) (all <i>P</i><0.05). Pre-pregnancy BMI [(28.0±4.9), (30.9±4.7) vs (25.4±5.1) kg/m²] and BMI at HSAT monitoring [(30.1±4.5), (31.8±6.5) vs (27.2±4.4) kg/m²], neck circumference [(36.7±2.8), (38.5±3.0) vs (35.3±2.5) cm], AHI [<i>M</i>(<i>Q</i>₁,<i>Q</i>₃)][7.9 (6.0, 10.7), 22.5 (18.3, 30.9) vs 1.8 (1.0, 3.8)/h], and ODI [7.8 (6.2, 11.1), 21.4 (17.7, 28.4) vs 2.1 (1.0, 3.8)/h] of mild OSAHS group and moderate-to-severe OSAHS group were all higher than those in the non-OSAHS group (all <i>P</i><0.05). Differences in HDP, GDM, Apgar score at 5 min, and the ratio of placental weight to birth weight were statistically significant among the three groups (all <i>P</i><0.05). The proportion of GDM [24.4% (11/45) vs 10.6% (26/245)] and the ratio of placental weight to birth weight [(0.19±0.04) vs (0.18±0.03) g] were both higher in the moderate-to-severe OSAHS group than those in the non-OSAHS group; and the gestational age at delivery [(37.4±2.2) vs (38.1±2.2) weeks], neonatal birth weight [(2, 961.2±769.8) vs (3, 088.8±680.9) g], and Apgar score at 5 min [(9.7±1.5) vs (10.0±0.3)] were all lower than those in the non-OSAHS group (all <i>P</i><0.05). <b>Conclusion:</b> Compared to the non-OSAHS group, pregnant women with moderate-to-severe OSAHS have a higher proportion of HDP and GDM, earlier gestational age at delivery, an increased ratio of placental weight to birth weight and lower neonatal birth weight.