Sleep-Disordered Breathing and Gestational Diabetes Mellitus

A meta-analysis of 9,795 participants enrolled in epidemiological observational studies

  1. Michelle A. Williams, SCD1
  1. 1Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
  2. 2Harvard Medical School, Countway Library of Medicine, Boston, Massachusetts
  3. 3Division of Sleep Medicine, Harvard Medical School, Brigham and Women’s Hospital and Beth Israel Medical Center, Boston, Massachusetts.
  1. Corresponding author: Miguel Angel Luque-Fernandez, mluquefe{at}


OBJECTIVE Recently, sleep-disordered breathing (SDB) has been reported to be associated with the development of gestational diabetes mellitus (GDM). Accordingly, as this is emergent area of research that has significant clinical relevance, the objective of this meta-analysis is to examine the relationship between SDB with GDM.

RESEARCH DESIGN AND METHODS We searched several electronic databases for all of the studies published before January 2013 and reviewed references of published articles. Meta-analytic procedures were used to estimate the unadjusted and BMI-adjusted odds ratios (ORs) using a random effects model. Significant values, weighted effect sizes, and 95% CIs were calculated, and tests of homogeneity of variance were performed.

RESULTS Results from nine independent studies with a total of 9,795 pregnant women showed that SDB was significantly associated with an increased risk of GDM. Women with SDB had a more than threefold increased risk of GDM, with a pooled BMI-adjusted OR 3.06 (95% CI 1.89–4.96).

CONCLUSIONS These findings demonstrate a significant association between SDB and GDM that is evident even after considered confounding by obesity. This meta-analysis indicates a need to evaluate the role of early recognition and treatment of SDB early during pregnancy.


  • Received April 1, 2013.
  • Accepted June 15, 2013.

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