{"doi":"10.1001/jamanetworkopen.2024.27557","title":"Continuous Positive Airway Pressure Treatment and Hypertensive Adverse Outcomes in Pregnancy","abstract":"<jats:sec id=\"ab-zoi240850-4\"><jats:title>Importance</jats:title><jats:p>Pregnancy may contribute to the development or exacerbation of obstructive sleep apnea (OSA) and increase the risk of gestational complications. Continuous positive airway pressure (CPAP) is the first-line and criterion standard treatment for OSA and is regarded as the most feasible choice during pregnancy. However, the association between CPAP therapy in pregnant women with OSA and reduced gestational complications remains inconclusive.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-5\"><jats:title>Objective</jats:title><jats:p>To investigate the association between CPAP therapy in pregnant women with OSA and the reduction of adverse hypertensive outcomes during gestation.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-6\"><jats:title>Data Sources</jats:title><jats:p>Keyword searches of PubMed, Embase, and the Cochrane Database of Systematic Reviews and Clinical Trials were conducted from inception to November 5, 2023.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-7\"><jats:title>Study Selection</jats:title><jats:p>Original studies reporting the treatment effect of CPAP use on lowering hypertension and preeclampsia risks in pregnant women with OSA were selected.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-8\"><jats:title>Data Extraction and Synthesis</jats:title><jats:p>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed in the reporting of reviews. Data were independently extracted by 2 authors. Random-effects model meta-analyses were performed and risk ratios (RRs) reported. Subgroup analysis, meta-regression based on age and body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and publication bias assessment were also conducted.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-9\"><jats:title>Main Outcome and Measures</jats:title><jats:p>The primary outcome was the RR of gestational hypertension and preeclampsia between pregnant women with OSA receiving CPAP treatment and those who did not receive CPAP treatment.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-10\"><jats:title>Results</jats:title><jats:p>Six original studies in 809 participants (mean age, 31.4 years; mean BMI, 34.0) were identified and systematically reviewed for meta-analysis. The pooled results showed significant differences between the intervention (CPAP use) and the control (non-CPAP use) groups in reducing the risk of gestational hypertension (RR, 0.65; 95% CI, 0.47-0.89; <jats:italic>P</jats:italic> = .008) and preeclampsia (RR, 0.70; 95% CI, 0.50-0.98; <jats:italic>P</jats:italic> = .04). Meta-regression revealed that patients’ age (coefficient, −0.0190; <jats:italic>P</jats:italic> = .83) and BMI (coefficient, −0.0042; <jats:italic>P</jats:italic> = .87) were not correlated with reduction of risk of hypertension and preeclampsia.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-11\"><jats:title>Conclusions and Relevance</jats:title><jats:p>These findings suggest that implementing CPAP treatment in pregnant women with OSA may reduce the risk of gestational hypertension and preeclampsia.</jats:p></jats:sec>","journal":"JAMA Network Open","year":2024,"id":617190,"datarank":0.647112233607986,"base_score":3.044522437723423,"endowment":3.044522437723423,"self_citation_contribution":0.4566783656585135,"citation_network_contribution":0.19043386794947245,"self_endowment_contribution":0.4566783656585135,"citer_contribution":0.19043386794947245,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":19,"citers_with_citation_signal":10,"citers_with_endowment":10,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1591521,"name":"Yun-Chen Chang","orcid":null,"position":1,"is_corresponding":false},{"id":1591523,"name":"Liang-Wei Tseng","orcid":null,"position":2,"is_corresponding":false},{"id":1591524,"name":"Wan-Ni Lin","orcid":null,"position":3,"is_corresponding":false},{"id":1591525,"name":"Chun-Ting Lu","orcid":null,"position":4,"is_corresponding":false},{"id":1591527,"name":"Li-Ang Lee","orcid":null,"position":5,"is_corresponding":false},{"id":1591528,"name":"Tuan-Jen Fang","orcid":null,"position":6,"is_corresponding":false},{"id":1591529,"name":"Wen-Nuan Cheng","orcid":null,"position":7,"is_corresponding":false},{"id":1591530,"name":"Hsueh-Yu Li","orcid":null,"position":8,"is_corresponding":false},{"id":1591519,"name":"Yi-Chieh Lee","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Continuous Positive Airway Pressure Treatment and Hypertensive Adverse Outcomes in Pregnancy","abstract":"<jats:sec id=\"ab-zoi240850-4\"><jats:title>Importance</jats:title><jats:p>Pregnancy may contribute to the development or exacerbation of obstructive sleep apnea (OSA) and increase the risk of gestational complications. Continuous positive airway pressure (CPAP) is the first-line and criterion standard treatment for OSA and is regarded as the most feasible choice during pregnancy. However, the association between CPAP therapy in pregnant women with OSA and reduced gestational complications remains inconclusive.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-5\"><jats:title>Objective</jats:title><jats:p>To investigate the association between CPAP therapy in pregnant women with OSA and the reduction of adverse hypertensive outcomes during gestation.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-6\"><jats:title>Data Sources</jats:title><jats:p>Keyword searches of PubMed, Embase, and the Cochrane Database of Systematic Reviews and Clinical Trials were conducted from inception to November 5, 2023.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-7\"><jats:title>Study Selection</jats:title><jats:p>Original studies reporting the treatment effect of CPAP use on lowering hypertension and preeclampsia risks in pregnant women with OSA were selected.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-8\"><jats:title>Data Extraction and Synthesis</jats:title><jats:p>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed in the reporting of reviews. Data were independently extracted by 2 authors. Random-effects model meta-analyses were performed and risk ratios (RRs) reported. Subgroup analysis, meta-regression based on age and body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and publication bias assessment were also conducted.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-9\"><jats:title>Main Outcome and Measures</jats:title><jats:p>The primary outcome was the RR of gestational hypertension and preeclampsia between pregnant women with OSA receiving CPAP treatment and those who did not receive CPAP treatment.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-10\"><jats:title>Results</jats:title><jats:p>Six original studies in 809 participants (mean age, 31.4 years; mean BMI, 34.0) were identified and systematically reviewed for meta-analysis. The pooled results showed significant differences between the intervention (CPAP use) and the control (non-CPAP use) groups in reducing the risk of gestational hypertension (RR, 0.65; 95% CI, 0.47-0.89; <jats:italic>P</jats:italic> = .008) and preeclampsia (RR, 0.70; 95% CI, 0.50-0.98; <jats:italic>P</jats:italic> = .04). Meta-regression revealed that patients’ age (coefficient, −0.0190; <jats:italic>P</jats:italic> = .83) and BMI (coefficient, −0.0042; <jats:italic>P</jats:italic> = .87) were not correlated with reduction of risk of hypertension and preeclampsia.</jats:p></jats:sec><jats:sec id=\"ab-zoi240850-11\"><jats:title>Conclusions and Relevance</jats:title><jats:p>These findings suggest that implementing CPAP treatment in pregnant women with OSA may reduce the risk of gestational hypertension and preeclampsia.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":2.995732273553991,"endowment":2.995732273553991,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39136943","pmcid":"PMC11322849","openalex_id":"https://openalex.org/W4401541793","authors":[],"funders":[],"total_grants":0,"fwci":4.5689,"citation_percentile":0.95795703,"influential_citations":0,"citation_trend":[{"year":2024,"count":2},{"year":2025,"count":9},{"year":2026,"count":8}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://doi.org/10.1001/jamanetworkopen.2024.27557","host_type":"journal"},{"url":"https://doi.org/10.1001/jamanetworkopen.2024.27557","host_type":"publisher"},{"url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2822293/lee_2024_oi_240850_1722953013.79741.pdf","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39136943","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11322849","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC11322849","host_type":"Europe_PMC"}],"fields_of_study":["Obstructive Sleep Apnea Research","Pregnancy and Medication Impact","Tracheal and airway disorders"],"mesh_terms":["Adult","Female","Humans","Pre-Eclampsia","Pregnancy","Pregnancy Outcome","Sleep Apnea, Obstructive","Continuous Positive Airway Pressure","Hypertension, Pregnancy-Induced"],"keywords":["Medicine","Gestational hypertension","Preeclampsia","Pregnancy","Continuous positive airway pressure","Gestational age","Body mass index","Obstructive sleep apnea","Exacerbation","Obstetrics","Meta-analysis","Relative risk","Systematic review","Birth weight","Pediatrics","MEDLINE","Internal medicine","Confidence interval"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T01:04:46.249669Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}