{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:43:00Z","timestamp":1793047380929,"version":"4.5.0"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Pregnancy may contribute to the development or exacerbation of obstructive sleep apnea (OSA) and increase the risk of gestational complications. Continuous positive airway pressure (CPAP) is the first-line and criterion standard treatment for OSA and is regarded as the most feasible choice during pregnancy. However, the association between CPAP therapy in pregnant women with OSA and reduced gestational complications remains inconclusive.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the association between CPAP therapy in pregnant women with OSA and the reduction of adverse hypertensive outcomes during gestation.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n Keyword searches of PubMed, Embase, and the Cochrane Database of Systematic Reviews and Clinical Trials were conducted from inception to November 5, 2023.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Original studies reporting the treatment effect of CPAP use on lowering hypertension and preeclampsia risks in pregnant women with OSA were selected.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed in the reporting of reviews. Data were independently extracted by 2 authors. Random-effects model meta-analyses were performed and risk ratios (RRs) reported. Subgroup analysis, meta-regression based on age and body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and publication bias assessment were also conducted.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n The primary outcome was the RR of gestational hypertension and preeclampsia between pregnant women with OSA receiving CPAP treatment and those who did not receive CPAP treatment.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Six original studies in 809 participants (mean age, 31.4 years; mean BMI, 34.0) were identified and systematically reviewed for meta-analysis. The pooled results showed significant differences between the intervention (CPAP use) and the control (non-CPAP use) groups in reducing the risk of gestational hypertension (RR, 0.65; 95% CI, 0.47-0.89;\n P<\/jats:italic>\n \u2009=\u2009.008) and preeclampsia (RR, 0.70; 95% CI, 0.50-0.98;\n P<\/jats:italic>\n \u2009=\u2009.04). Meta-regression revealed that patients\u2019 age (coefficient, \u22120.0190;\n P<\/jats:italic>\n \u2009=\u2009.83) and BMI (coefficient, \u22120.0042;\n P<\/jats:italic>\n \u2009=\u2009.87) were not correlated with reduction of risk of hypertension and preeclampsia.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n These findings suggest that implementing CPAP treatment in pregnant women with OSA may reduce the risk of gestational hypertension and preeclampsia.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.27557","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T11:13:24Z","timestamp":1723547604000},"page":"e2427557","source":"Crossref","is-referenced-by-count":23,"title":["Continuous Positive Airway Pressure Treatment and Hypertensive Adverse Outcomes in Pregnancy"],"prefix":"10.1001","volume":"7","author":[{"given":"Yi-Chieh","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan"},{"name":"London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Chen","family":"Chang","sequence":"additional","affiliation":[{"name":"Sleep Center, Department of Otolaryngology\u2013Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang-Wei","family":"Tseng","sequence":"additional","affiliation":[{"name":"Division of Chinese Acupuncture and Traumatology, Center of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Ni","family":"Lin","sequence":"additional","affiliation":[{"name":"Sleep Center, Department of Otolaryngology\u2013Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Ting","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ang","family":"Lee","sequence":"additional","affiliation":[{"name":"Sleep Center, Department of Otolaryngology\u2013Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuan-Jen","family":"Fang","sequence":"additional","affiliation":[{"name":"Sleep Center, Department of Otolaryngology\u2013Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Nuan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Sports Sciences, University of Taipei, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsueh-Yu","family":"Li","sequence":"additional","affiliation":[{"name":"Sleep Center, Department of Otolaryngology\u2013Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,8,13]]},"reference":[{"issue":"14","key":"zoi240850r1","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1001\/jama.2020.3514","article-title":"Diagnosis and management of obstructive sleep apnea: a review.","volume":"323","author":"Gottlieb","year":"2020","journal-title":"JAMA"},{"issue":"7","key":"zoi240850r2","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1111\/resp.v25.7","article-title":"Global burden of sleep-disordered breathing and its implications.","volume":"25","author":"Lyons","year":"2020","journal-title":"Respirology"},{"issue":"5","key":"zoi240850r3","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1093\/sleep\/22.5.667","article-title":"Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research: the report of an American Academy of Sleep Medicine Task Force.","volume":"22","year":"1999","journal-title":"Sleep"},{"issue":"19","key":"zoi240850r5","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1056\/NEJM200005113421901","article-title":"Prospective study of the association between sleep-disordered breathing and hypertension.","volume":"342","author":"Peppard","year":"2000","journal-title":"N Engl J Med"},{"issue":"9657","key":"zoi240850r6","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/S0140-6736(08)61622-0","article-title":"Obstructive sleep apnoea and its cardiovascular consequences.","volume":"373","author":"Bradley","year":"2009","journal-title":"Lancet"},{"issue":"19","key":"zoi240850r7","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1056\/NEJMoa043104","article-title":"Obstructive sleep apnea as a risk factor for stroke and death.","volume":"353","author":"Yaggi","year":"2005","journal-title":"N Engl J Med"},{"key":"zoi240850r8","first-page":"S102","article-title":"Cognitive function in the sleep apnea\/hypopnea syndrome (SAHS).","volume":"23","author":"Engleman","year":"2000","journal-title":"Sleep"},{"key":"zoi240850r9","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.sleep.2017.06.035","article-title":"Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort.","volume":"38","author":"Bourjeily","year":"2017","journal-title":"Sleep Med"},{"issue":"2","key":"zoi240850r10","doi-asserted-by":"publisher","first-page":"158","DOI":"10.3122\/jabfm.2009.02.080057","article-title":"Sleep-disordered breathing during pregnancy.","volume":"22","author":"Venkata","year":"2009","journal-title":"J Am Board Fam Med"},{"issue":"2","key":"zoi240850r11","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1183\/09031936.06.00148204","article-title":"Sleep-disordered breathing and upper airway size in pregnancy and post-partum.","volume":"27","author":"Izci","year":"2006","journal-title":"Eur Respir J"},{"issue":"3","key":"zoi240850r12","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1258\/om.2009.090015","article-title":"Sleep disorders in pregnancy.","volume":"2","author":"Bourjeily","year":"2009","journal-title":"Obstet Med"},{"issue":"1","key":"zoi240850r13","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1097\/AOG.0000000000001805","article-title":"Association between sleep-disordered breathing and hypertensive disorders of pregnancy and gestational diabetes mellitus.","volume":"129","author":"Facco","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"3","key":"zoi240850r14","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1183\/09031936.00122607","article-title":"Obstructive sleep apnoea and its association with gestational hypertension.","volume":"33","author":"Champagne","year":"2009","journal-title":"Eur Respir J"},{"key":"zoi240850r15","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/j.ejogrb.2016.12.013","article-title":"Association of obstructive sleep apnea with adverse pregnancy-related outcomes in military hospitals.","volume":"210","author":"Spence","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"2","key":"zoi240850r16","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2023.38.e8","article-title":"Obstructive sleep apnea is associated with late-onset preeclampsia in overweight pregnant women in Korea.","volume":"38","author":"Ryu","year":"2023","journal-title":"J Korean Med Sci"},{"key":"zoi240850r17","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.sleep.2019.01.019","article-title":"Maternal obstructive sleep apnea and neonatal birth outcomes in a population based sample.","volume":"66","author":"Bourjeily","year":"2020","journal-title":"Sleep Med"},{"issue":"3","key":"zoi240850r18","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1093\/sleep\/29.3.375","article-title":"Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders.","volume":"29","author":"Kushida","year":"2006","journal-title":"Sleep"},{"issue":"3","key":"zoi240850r19","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.anl.2020.03.007","article-title":"How to manage continuous positive airway pressure (CPAP) failure - hybrid surgery and integrated treatment.","volume":"47","author":"Li","year":"2020","journal-title":"Auris Nasus Larynx"},{"issue":"4","key":"zoi240850r20","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1016\/j.chest.2017.10.011","article-title":"Maternal sleep-disordered breathing.","volume":"153","author":"Pamidi","year":"2018","journal-title":"Chest"},{"issue":"2","key":"zoi240850r21","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1007\/s11325-022-02669-0","article-title":"Continuous positive airway pressure treatment of obstructive sleep apnea and hypertensive complications in high-risk pregnancy.","volume":"27","author":"Rice","year":"2023","journal-title":"Sleep Breath"},{"issue":"1","key":"zoi240850r22","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1007\/s11325-021-02397-x","article-title":"The effect of continuous positive airway pressure treatment on hypertensive disorder in pregnant women with obstructive sleep apnea.","volume":"26","author":"Stajic","year":"2022","journal-title":"Sleep Breath"},{"issue":"3","key":"zoi240850r23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100571","article-title":"A randomized controlled trial of sleep study surveillance with targeted autoregulated positive airway pressure therapy for obstructive sleep apnea in pregnancy.","volume":"4","author":"Kalkhoff","year":"2022","journal-title":"Am J Obstet Gynecol MFM"},{"key":"zoi240850r25","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials.","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"issue":"1","key":"zoi240850r27","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1186\/s12931-023-02445-y","article-title":"Treatment of obstructive sleep apnea in high risk pregnancy: a multicenter randomized controlled trial.","volume":"24","author":"Tantrakul","year":"2023","journal-title":"Respir Res"},{"issue":"3","key":"zoi240850r28","doi-asserted-by":"publisher","first-page":"327","DOI":"10.5664\/jcsm.6972","article-title":"Continuous positive airway pressure therapy in gestational diabetes with obstructive sleep apnea: a randomized controlled trial.","volume":"14","author":"Chirakalwasan","year":"2018","journal-title":"J Clin Sleep Med"},{"issue":"3","key":"zoi240850r29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100840","article-title":"A trial of positive airway pressure for the treatment of sleep apnea in pregnancy.","volume":"5","author":"Facco","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"5","key":"zoi240850r30","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1038\/s41581-019-0119-6","article-title":"Pre-eclampsia: pathogenesis, novel diagnostics and therapies.","volume":"15","author":"Phipps","year":"2019","journal-title":"Nat Rev Nephrol"},{"issue":"1","key":"zoi240850r31","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1177\/1753495X17708949","article-title":"Sleep disordered breathing controlled by CPAP and sFlt-1 in a pregnant patient with chronic hypertension: case report and literature review.","volume":"11","author":"Daly","year":"2018","journal-title":"Obstet Med"},{"issue":"3","key":"zoi240850r32","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1111\/ajo.v63.3","article-title":"The effectiveness of continuous positive airway pressure for treating obstructive sleep apnoea in pregnancy: a systematic review.","volume":"63","author":"Nugent","year":"2023","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"2","key":"zoi240850r33","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1097\/AOG.0000000000004866","article-title":"Common sleep disorders in pregnancy.","volume":"140","author":"Facco","year":"2022","journal-title":"Obstet Gynecol"},{"key":"zoi240850r4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/B978-0-323-44339-5.00002-X","volume-title":"Sleep Apnea and Snoring","author":"Huon","year":"2020","edition":"2nd ed"},{"key":"zoi240850r24","author":"Lee"},{"key":"zoi240850r26","unstructured":"Wells? GA, Shea? B, O\u2019Connell? D, . The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute; 2021. Accessed July 10, 2024. https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2822293\/lee_2024_oi_240850_1722953013.79741.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T11:13:29Z","timestamp":1723547609000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2822293"}},"subtitle":["A Systematic Review and Meta-Analysis"],"short-title":[],"issued":{"date-parts":[[2024,8,13]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.27557","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,13]]}}}