Obstructive sleep apnea-associated hypertensive disorders in pregnancy: a literature review and clinical management strategies

Aug 3, 2025Reproductive biology and endocrinology : RB&E

High Blood Pressure in Pregnancy Linked to Sleep Apnea: Summary and Care Approaches

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Abstract

(OSA) is linked to (HDP), with mechanisms such as intermittent hypoxia and systemic inflammation discussed.

OSA may contribute to the development of HDP through various mechanisms.
Potential pathways include intermittent hypoxia, oxidative stress, and systemic inflammation.
Dysregulation of the sympathetic nervous system and endothelial dysfunction could also play roles.
Current treatments like CPAP therapy show variable effectiveness in managing HDP symptoms.
Future research should prioritize improved OSA screening and diagnostic tools during pregnancy.
Large-scale, randomized controlled trials are needed to evaluate combination therapies and develop clinical guidelines.

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(OSA) has long been recognized as a significant risk factor for hypertension, and in recent years, its association with (HDP) has gained increasing attention, especially in the unique population of pregnant women. However, this relationship remains underappreciated in clinical practice. While early studies have suggested a link between OSA and adverse pregnancy outcomes, the mechanisms connecting OSA to HDP are not fully understood. This literature review explores potential pathways, including intermittent hypoxia, oxidative stress, systemic inflammation, dysregulation of the sympathetic nervous system, endothelial dysfunction, and atherosclerosis. It also examines current treatments, especially CPAP therapy, and its variable effectiveness in managing HDP symptoms, as well as potential alternatives such as throat strengthening exercises and external hypoglossal stimulation. Future research should focus on improving OSA screening during pregnancy, developing better diagnostic tools, and integrating routine OSA evaluations in prenatal care for early intervention. Clarifying the mechanisms linking OSA and HDP will help refine treatment strategies. Large-scale, randomized controlled trials are needed to assess the efficacy of combination therapies and develop evidence-based clinical guidelines.

Key numbers

2.22

Increased Risk of Preeclampsia

Adjusted odds ratio for preeclampsia in women with .

19 to 7%

CPAP Treatment Effectiveness

Incidence of preeclampsia before and after CPAP treatment.

3.6 to 27%

Prevalence

Estimated prevalence of in pregnant women.

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Obstructive sleep apnea-associated hypertensive disorders in pregnancy: a literature review and clinical management strategies

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