Work

The endothelin‐1 system among high‐risk pregnant women with obstructive sleep apnea

Year: 2025

Type: article

Abstract: Summary Obstructive sleep apnea is associated with gestational hypertension. Elevated endothelin‐1 is a proposed factor in the pathogenesis of gestational hypertension. However, the association between endothelin‐1 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‐1 concentrations were evaluated using Western blot, quantitative real‐time polymerase chain reaction, immunohistochemistry, and enzyme‐linked immunosorbent assay. Multivariable analyses were conducted comparing endothelin‐1 levels between obstructive sleep apnea and non‐obstructive sleep apnea groups. There was no significant difference in band intensity or quantitative densitometric evaluation when comparing obstructive sleep apnea‐positive and ‐negative groups ( p = 0.42). mRNA expression of endothelin‐1 did not differ in placental tissues between groups ( p = 0.73). There was no significant difference in endothelin‐1 median plasma concentrations between groups ( p = 0.95). However, there was a significant sixfold increase in the rate of endothelin‐1 elevation > 90th percentile (adjusted odds ratio 5.9, 95% confidence interval 1.05–32.7) after adjusting for confounding by body mass index. Additionally, lower pre‐pregnancy body mass index (< 32 kg m −2 ) was associated with plasma endothelin‐1 > 11 at delivery ( p < 0.01), and class 3 obesity appeared protective for having elevated plasma endothelin‐1 > 90th percentile ( p = 0.03). Overall, in this prospective cohort of high‐risk pregnant patients, obstructive sleep apnea was associated with an increased rate of markedly elevated (> 90th percentile) endothelin‐1 plasma levels. Lower pre‐pregnancy body mass index among patients with obesity was associated with elevated endothelin‐1 plasma levels. Obstructive sleep apnea screening questionnaires focused on high body mass index may result in underestimated risk.

Source: Journal of Sleep Research

DOI: 10.1111/jsr.70008