University of Wisconsin–Madison Medical College of Wisconsin

Are Symptoms of Obstructive Sleep Apnea During Pregnancy Associated With Autism Spectrum Disorder in Children: A Case-Control Study

Julia Nick, BS; Kristin Seaborg, MD; Kathleen Kastner, MD; Mihaela Bazalakova, MD, PhD; Kathleen Antony, MD, MSCI

WMJ. 2024;123(1):18-23.

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Background: Obstructive sleep apnea complicates 10% to 32% or greater of pregnancies, however, reports on long-term effects on the children of pregnancies affected by obstructive sleep apnea are limited.

Objective: We sought to test the hypothesis that the children of pregnant people with symptoms of obstructive sleep apnea during pregnancy have an increased incidence of autism spectrum disorder.

Methods: This was a case-control study comparing the pregnancies of people whose children were later diagnosed with autism spectrum disorder without a known associated genetic condition to those whose children were diagnosed with autism spectrum disorder with a known associated genetic condition.

Results: Of the 51 total parents who were eligible and consented to participate, 4 had a child with autism associated with a known genetic condition, and 47 had a child with autism with no known genetic condition. The prevalence of any snoring (50.0% and 36.2%, respectively) and daytime tiredness (75.0% and 89.4%, respectively) were similar between both groups.

Conclusions: In this study, the prevalence of any snoring and falling asleep while driving during pregnancy was higher in the sampled population than typically reported in pregnant people. While the sample size for this study was small, our preliminary results suggest that parents of children with autism have a high prevalence of sleep-related concerns during their pregnancies, which indicates the need for further investigation – especially for obstructive sleep apnea. Future studies exploring the neurodevelopmental outcomes of children of a cohort of pregnant people with known presence or absence of obstructive sleep apnea during pregnancy is warranted.

Author Affiliations: Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, Wisconsin (Nick, Antony); University of Wisconsin-Madison, Madison, Wis (Nick); Section of Pediatric Neurology, Wisconsin Sleep, UWSMPH, Madison, Wis (Seaborg); Division of Developmental Pediatrics and Rehabilitation Medicine, Department of Pediatrics, UWSMPH, Madison, Wis (Kastner); Department of Neurology, Wisconsin Sleep, UWSMPH, Madison, Wis (Bazalakova).
Corresponding Author: Kathleen Antony, MD, MSCI, Associate Professor, Department of Obstetrics and Gynecology, 1010 Mound St, Madison, WI 53715; phone 608.417.5971; email; ORCID ID 0000-0003-3537-8030.
Funding/Support: This project was supported by the Clinical and Translational Science Award (CTSA) program, through the National Institutes of Health (NIH) National Center for Advancing Translational Sciences (NCATS), grant UL1TR002373. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Financial Disclosures: None declared.
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