{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:26:12Z","timestamp":1791930372189,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Obstructive sleep apnea is associated with gestational hypertension. Elevated endothelin\u20101 is a proposed factor in the pathogenesis of gestational hypertension. However, the association between endothelin\u20101 and obstructive sleep apnea complicating pregnancy is unknown. In a prospective cohort of 60 pregnant patients with obesity but without confounding comorbid conditions (i.e. cardiac\/pulmonary disease), plasma and placental samples were collected at delivery in 30 women with obstructive sleep apnea and 30 without. Endothelin\u20101 concentrations were evaluated using Western blot, quantitative real\u2010time polymerase chain reaction, immunohistochemistry, and enzyme\u2010linked immunosorbent assay. Multivariable analyses were conducted comparing endothelin\u20101 levels between obstructive sleep apnea and non\u2010obstructive sleep apnea groups. There was no significant difference in band intensity or quantitative densitometric evaluation when comparing obstructive sleep apnea\u2010positive and \u2010negative groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.42). mRNA expression of endothelin\u20101 did not differ in placental tissues between groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.73). There was no significant difference in endothelin\u20101 median plasma concentrations between groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.95). However, there was a significant sixfold increase in the rate of endothelin\u20101 elevation &gt;\u200990th percentile (adjusted odds ratio 5.9, 95% confidence interval 1.05\u201332.7) after adjusting for confounding by body mass index. Additionally, lower pre\u2010pregnancy body mass index (&lt;\u200932\u2005kg\u2005m\n                    <jats:sup>\u22122<\/jats:sup>\n                    ) was associated with plasma endothelin\u20101\u2009&gt;\u200911 at delivery (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01), and class 3 obesity appeared protective for having elevated plasma endothelin\u20101\u2009&gt;\u200990th percentile (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.03). Overall, in this prospective cohort of high\u2010risk pregnant patients, obstructive sleep apnea was associated with an increased rate of markedly elevated (&gt;\u200990th percentile) endothelin\u20101 plasma levels. Lower pre\u2010pregnancy body mass index among patients with obesity was associated with elevated endothelin\u20101 plasma levels. Obstructive sleep apnea screening questionnaires focused on high body mass index may result in underestimated risk.\n                  <\/jats:p>","DOI":"10.1111\/jsr.70008","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T01:01:15Z","timestamp":1739235675000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The endothelin\u20101 system among high\u2010risk pregnant women with obstructive sleep apnea"],"prefix":"10.1111","volume":"34","author":[{"given":"Samantha","family":"Shirk","sequence":"first","affiliation":[{"name":"Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology Wake Forest University School of Medicine  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L.","family":"Kozakiewicz","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology Wake Forest University School of Medicine  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7392-4509","authenticated-orcid":false,"given":"Kristin N.","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Pulmonology, Critical Care, Allergy and Immunologic Diseases Wake Forest University School of Medicine  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang Rui","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Pulmonology, Critical Care, Allergy and Immunologic Diseases Wake Forest University School of Medicine  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit K.","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Wake Forest University School of Medicine  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Stamilio","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology Wake Forest University School of Medicine  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology Wake Forest University School of Medicine  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail L.","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Pulmonology, Critical Care, Allergy and Immunologic Diseases Wake Forest University School of Medicine  Winston Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Namen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Pulmonology, Critical Care, Allergy and Immunologic Diseases Wake Forest University School of Medicine  Winston Salem North Carolina 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