Questionnaire-Based Assessment of Obstructive Sleep Apnea Risk During Pregnancy: Associations with Metabolic Parameters and Family History of Diabetes.

Objective

Obstructive sleep apnea (OSA) during pregnancy is associated with adverse maternal and fetal outcomes, yet commonly used screening questionnaires may perform differently because of pregnancy-specific physiological changes. This study compared questionnaire-based OSA risk classifications obtained using the Berlin Questionnaire and STOP-BANG and examined their associations with metabolic parameters and diabetes-related history.

Methods

This cross-sectional study included 210 pregnant women attending a tertiary obstetrics clinic. Berlin Questionnaire high risk was defined as positivity in at least two categories. STOP-BANG scores of 0-2, 3-4, and 5-8 indicated low, moderate, and high risk, respectively. Sociodemographic, obstetric, anthropometric, and biochemical variables were analyzed using multivariable logistic regression.

Results

The Berlin Questionnaire classified 34 participants (16.2%) as high risk. STOP-BANG classified 183 (87.1%) as low risk, 5 (2.4%) as moderate risk, and 22 (10.5%) as high risk. Higher current weight was associated with increased questionnaire-based OSA risk according to both tools. In the Berlin model, HbA1c, BMI, and family history of diabetes were independently associated with high questionnaire-based OSA risk. No independent associations were identified in the STOP-BANG model. Although the Berlin model had 83.3% overall accuracy, it correctly classified only 2.9% of high-risk participants.

Conclusions

The questionnaires identified different patterns of OSA risk. Findings were instrument-specific and do not indicate confirmed OSA. Given the absence of polysomnography, modest model performance, and limited high-risk classification, the results should be interpreted cautiously.