{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:21:07Z","timestamp":1787170867452,"version":"build-2736575974"},"reference-count":35,"publisher":"IMR Press","issue":"4","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background: Obstructive sleep apnea (OSA) and intermittent maternal hypoxia during pregnancy have been hypothesised to impact fetal heart rate (FHR). To evidence this possible link, we performed a systematic review of the current evidence about maternal OSA and FHR alteration. Methods: The following databases were analysed from the inception to June 2024: Cochrane Library, PubMed-Medline, EMBASE, Web of Science, and Google Scholar. We included studies with pregnant women affected by OSA, and FHR assessed via cardiotocography or fetal electrocardiography. Studies without polysomnography or home sleep testing, cross-over designs, or non-English publications were excluded. Results: 168 studies were screened, and six were included. Five were prospective observational studies, and one was a case report. Maternal age showed a value from 26.6\u202f\u00b1\u202f7.1 to 34.8\u202f\u00b1\u202f3.3 years, and gestational age ranged from 32.1\u202f\u00b1\u202f3.4 to 39.4\u202f\u00b1\u202f1.0 weeks. The body mass index (BMI) values ranged between 27.5\u202f\u00b1\u202f7.2 and 55 kg\/m2. Polysomnography was the primary diagnostic tool for OSA in most studies; one study utilised a home sleep test. Apnea\/hypopnea episodes frequency varied from 8.4 to 159 events per hour. Findings about the FHR alterations were discordant: three studies did not report an association, other three observed FHR changes linked to maternal respiratory events. Conclusion: Our systematic review evidenced a significant variability about the maternal OSA impact on fetal heart rate. The study\u2019s results were contradictory. These inconsistencies also derive from different study designs, sample sizes, and outcomes analysed. Further studies are necessary to evidence the real impact of the OSA on the fetal cardiac response. Systematic Review Registration: PROSPERO (CRD42024533801).<\/jats:p>","DOI":"10.31083\/bjhm53217","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:17:23Z","timestamp":1777457843000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of Obstructive Sleep Apnea on Fetal Heart Rate: A Systematic Review"],"prefix":"10.31083","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6071-0245","authenticated-orcid":true,"given":"Marco","family":"La Verde","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9494-6942","authenticated-orcid":true,"given":"Maria Maddalena","family":"Marrapodi","sequence":"additional","affiliation":[{"name":"Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, 600077 Chennai, India"},{"name":"Pediatric Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosella","family":"Molitierno","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonietta","family":"Petillo","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9265-1772","authenticated-orcid":true,"given":"Hande","family":"Uzun\u00e7\u0131buk","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry, Trakya University, 22030 Edirne, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2629-9381","authenticated-orcid":true,"given":"Marco","family":"Di Blasio","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2311-9728","authenticated-orcid":true,"given":"Marco","family":"Cicci\u00f9","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Surgical and Biomedical Sciences, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8309-1272","authenticated-orcid":true,"given":"Giuseppe","family":"Minervini","sequence":"additional","affiliation":[{"name":"Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Kiserud T, Benachi A, Hecher K, Perez RG, Carvalho J, Piaggio G, et al. 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