Allostatic load in early pregnancy and sleep-disordered breathing

Figures & data

Figure 1. Flow diagram of the study participants included in the analysis. Abbreviations: Nulliparous Pregnancy Outcomes Study Monitoring-to-be; HHS, heart health study.

Table 1. Demographic and clinical characteristics between participants with high allostatic and low allostatic loads in pregnancy.

Variables	Study cohort N (%) N = 1771	High Allostatic Load ≥ 4 N = 620	Low Allostatic Load < 4 N = 1151	p-Value
BMI	26.8 ± 6.6	31 ± 7.4	24.1 ± 4.1	<0.001
Maternal Age > = 35	160 (9.0)	71 (11.5)	89 (7.7)	0.009
Race (Non-Hispanic Black)	231 (13.0)	99 (16.0)	132 (11.5)	0.007
Education (Some college or less)	683 (38.6)	286 (46.1)	397 (34.5)	<0.001
Gravidity > = 3	125 (7.1)	50 (8.1)	75 (6.5)	0.225
Smoking	286 (16.2)	122 (19.7)	164 (14.3)	0.003
Alcohol Use (ever)	1024 (71.7)	359 (57.9)	665 (57.8)	0.960
Prior Miscarriage	271 (15.3)	104 (16.8)	167 (14.5)	0.201
Prior Abdominal Surgery	189 (10.7)	79 (12.7)	110 (9.6)	0.038
Prior Bleeding at the First Trimester	122 (6.9)	50 (8.1)	72 (6.3)	0.153
≤ 200% of the federal poverty level	470 (32.5)	178 (36.1)	292 (30.6)	0.035
Government Health Insurance	474 (26.9)	192 (31.1)	282 (24.7)	0.004
Preexisting Diabetes	26 (1.5)	19 (3.1)	7 (0.6)	<0.001
Chronic Hypertension	41 (2.3)	32 (5.2)	9 (0.8)	<0.001
Neck Circumference	32 ± 3.1	34 ± 3.5	32 ± 2.3	<.0001
Hyperthyroid	19 (1.1)	7 (1.1)	12 (1.0)	0.866

Data are expressed as binary variables and as n (column %).

Figure 2. Adjusted logistic regression estimating the association between sleep-disordered breathing and allostatic load. Abbreviations: Ever, (SDB ever); CI confidence interval. *Adjusted Odds ratios and CIs were reported using unconditional logistic regression after adjusting for maternal age, education level, gravida, smoking status, health insurance status, preexisting diabetes, and chronic hypertension.

Table 2. Moderation of obesity in the association between sleep-disordered breathing outcomes and high allostatic load (≥ 4), unadjusted and adjusted logistic regression model estimates.

	Obese*N = 455	Non-obese*N = 1316	p Value
SDB (ever)	99 (21.7)	48 (3.7)	<0.001
uOR (95%CI)	2.4 (1.8–3.8)	3.3 (1.8–5.9)	0.388
aOR (95%CI)	2.3 (1.4–3.7)	3.2 (1.8–5.8)	0.387
Early-Pregnancy SDB	56 (13.1)	14 (1.1)	<0.001
uOR (95%CI)	1.7 (0.9–3.1)	5.4 (1.9–15.8)	0.066
aOR (95%CI)	1.6 (0.8–2.9)	5.0 (1.7–14.4)	0.071
Mid-Pregnancy SDB	76 (21.8)	39 (3.7)	<0.001
uOR (95%CI)	2.8 (1.6–4.9)	3.3 (1.7–6.3)	0.710
aOR (95%CI)	3.0 (1.7–5.5)	3.0 (1.5–5.9)	0.980

Data are expressed as binary variables and as n (column %); n: proportion of individuals with outcomes in each racial category.

uOR: unadjusted odds ratios; aOR: adjusted odds ratio; CI: confidence interval.

*Adjusted Odds ratios and CIs were reported using unconditional logistic regression after adjusting for maternal age, race, education level, gravida, smoking status, preexisting diabetes, chronic hypertension, and health insurance status.

*BMI was excluded from the allostatic load score.

Table 3. Adjusted logistic regression estimating the association between sleep-disordered breathing and allostatic load.

Sleep disorder breathing	High allostatic load** AL ≥ 4 (N = 524)	Low allostatic load** AL < 4 (N = 1247)	Odds ratio (95% confidence interval)
			Unadjusted	Adjusted*
SDB (ever)	93 (17.7)	54 (4.3)	4.8 (3.3–6.7)	2.6 (1.8–3.9)
Early-Pregnancy SDB	46 (8.8)	24 (2.0)	4.9 (3.0–8.2)	2.1 (1.2–3.7)
Mid-Pregnancy SDB	74 (14.2)	41 (3.3)	5.1 (3.4–7.6)	3.0 (1.9–4.7)

*Adjusted Odds ratios and CIs were reported using unconditional logistic regression after adjusting for maternal age, BMI, education level, gravida, smoking status, health insurance status, preexisting diabetes, and chronic hypertension.

**BMI was excluded from the allostatic load score.

Data availability statement

Data sharing is not applicable to this article as no new data were created or analyzed in this study.