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Licensed Unlicensed Requires Authentication Published by De Gruyter May 20, 2014

Placenta-secreted circulating markers in pregnant women with obstructive sleep apnea

  • Ghada Bourjeily EMAIL logo , Patrizia Curran , Kristen Butterfield , Hasina Maredia , Marshall Carpenter and Geralyn Lambert-Messerlian


Aims: Obstructive sleep apnea (OSA) is associated with placenta-mediated adverse clinical outcomes. We aimed at comparing placenta-secreted proteins, such as first and second trimester Down syndrome screening markers which have been linked to preeclampsia, and markers of angiogenesis in pregnant women with OSA, and pregnant controls at low risk for OSA.

Methods: A case-control study of pregnant women with OSA and controls at low risk for OSA was performed. Levels of first and second trimester markers were reported as multiple of median (MoM), and adjusted for body mass index (BMI). Stored samples were tested for markers of angiogenesis and adjusted for gestational age, BMI, and chronic hypertension.

Results: A total of 24 women with OSA and 166 controls had screening markers. BMI was higher in cases compared to controls, P=0.01. MoM levels of placenta associated plasma protein-A (PAPP-A) were significantly lower in cases versus controls, even after adjusting for BMI (0.52 IQR 0.48 vs. 1.01 IQR 0.63, P=0.009). The ratio of soluble vascular endothelial growth factor receptor 1 to placental growth factor was significantly higher in cases than controls, even after adjusting for confounders (4.42 IQR 2.52 vs. 2.93 IQR 2.01, P=0.009).

Conclusion: Circulating placenta-secreted glycoproteins and markers of angiogenesis are altered in pregnant women with OSA.

Corresponding author: Ghada Bourjeily, The Miriam Hospital, 146 West River Street, Suite 11C, Providence, RI 02904, USA, Tel.: +401-793-7358, Fax: +401-793-7404, E-mail:


The authors would like to thank Elizabeth Eklund and Cheryl Felber for their contributions to this research. (Both are employed by Women and Infants Hospital of Rhode Island and have nothing to disclose.)

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors report no conflict of interest.

Financial support: Dr. Bourjeily’s work was supported by the Perkins Charitable Foundation. The foundation did not have a role in the design, the data analysis, or manuscript preparation.


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Article note:

Data from this study were presented at the 26th and 27th Annual Meetings of the Associated Professional Sleep Societies’, June 9–13, 2012, in Boston, MA, and June 1–5, 2013, in Baltimore, MD.

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-2-13
Accepted: 2014-4-22
Published Online: 2014-5-20
Published in Print: 2015-1-1

©2015 by De Gruyter

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