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Volume 15 No. 06
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Accepted Papers

Scientific Investigations

Anthropometric Measures and Prediction of Maternal Sleep-Disordered Breathing

Ghada Bourjeily, MD1,2; Alison Chambers, PhD1,3; Myriam Salameh, MD2; Margaret H. Bublitz, PhD1,2; Amanpreet Kaur, MD1,2; Alexandra Coppa, BS2; Patricia Risica, PhD4; Geralyn Lambert-Messerlian, PhD1,5
1Warren Alpert Medical School at Brown University, Providence, Rhode Island; 2The Miriam Hospital, Department of Medicine, Providence, Rhode Island; 3Rhode Island Hospital, Department of Biostatistics, Providence, Rhode Island; 4Department of Epidemiology, Center for Health Equity Research, Brown University School of Public Health, Providence, Rhode Island; 5Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Providence, Rhode Island

Study Objectives:

Pregnant women are at risk for sleep-disordered breathing (SDB); however, screening methods in this dynamic population are not well studied. The aim of this study was to examine whether anthropometric measures can accurately predict SDB in pregnant women.


Pregnant women with snoring and overweight/obesity were recruited in the first trimester. Anthropometric measures were performed according to the International Standards for Anthropometric Assessment, including a seated neutral and extended neck Mallampati class. Home sleep apnea monitoring was performed using a level III device after completion of anthropometric assessment. SDB was defined as an apnea-hypopnea index ≥ 5 events/h of sleep. Pearson and Spearman tests examined correlations between various measures. Generalized linear models, sensitivity, specificity, and area under the curve as well as odds ratios were performed to test the model.


A total of 129 participants were recruited, and 23 had SDB. Average gestational age was 10.6 ± 1.9 weeks. Due to concerns over multicollinearity, the final model included extended Mallampati class and upright neck circumference. Neck circumference was significantly higher in participants with Mallampati classes 2/3 and grade 4 compared to participants with Mallampati class 1 (P = .0005). Increasing neck circumference was associated with higher odds of SDB (P = .0022). In Mallampati class 1, odds ratio for SDB was 2.89 (1.19, 7.03) per unit increase in neck circumference.


Modeling neck circumference while allowing for differences by Mallampati class showed a nearly threefold increase in the risk of SDB with increasing neck circumference in women with Mallampati class 1. Other potential sites of airway obstruction need to be investigated in future research.


Bourjeily G, Chambers A, Salameh M, Bublitz MH, Kaur A, Coppa A, Risica P, Lambert-Messerlian G. Anthropometric measures and prediction of maternal sleep-disordered breathing. J Clin Sleep Med. 2019;15(6):849–856.

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