0529 Feasibility of the REST Tracker Platform to Monitor Obese Pregnant Woman for the Onset of OSA Throughout Pregnancy

Introduction OSA during pregnancy is associated with increased risk for gestational-diabetes, hypertension, preeclampsia, and eclampsia, contributing to maternal and neonatal morbidity and mortality. Furthermore, OSA increases risk of chronic cardiovascular disease, well beyond pregnancy. Studies suggest the prevalence of OSA increases during pregnancy, as maternal BMI rises. Continuous evaluation is necessary as the risk increases throughout the course of the pregnancy, however this is not currently a standard practice. Sleep specialists have not provided a specific approach to assist obstetricians addressing the OSA concern, leaving a gap in our maternal health management. REST Technologies has developed the REST-Tracker, a Remote Patient Monitoring platform for the management of OSA patients and has been funded by the NIH to assess the feasibility of using this platform in the obese pregnant population at risk of developing OSA. Here, we present preliminary data using the REST-Tracker to assess for OSA throughout pregnancy in an at-risk population. Methods The REST-Tracker system manages data obtained from a Ring-Oximeter worn nightly by subjects whos data is processed through the FDA cleared SleepImage ™ system, assessing for OSA, providing sAHI3%/sAHI4% metrics. Subjects recruited from a high-risk obstetrics clinic. Inclusion-criteria: BMI >27, entry < 16 weeks gestational-age, Target=30 subjects monitored nightly into and through the third trimester. Results To date, 23 reliable subjects, two drop-outs from miscarriages, 21 currently providing data, 9 left to recruit. Initial-BMI Ave=38 (+/-6.6), Ave Initial-GA=8.9wks(+/-2.4), Initial sAHI3%/4%= 5.3 (+/-3.1) sAHI4%=2.3(+/-2.0) average monitoring to-date=12.4(+/-5) with 0 subjects demonstrating sustained moderate (sAHI4% > 15) or severe (sAHI4% >30) OSA. None of the subjects to-date demonstrate SaO2 < 90% to any significant degree, 3 subjects had the SaO2 drop < 90% >5 min on 3 nights, only 1 had 1 night with SaO2 < 88% >5 minutes (19 minutes). Conclusion If successful the REST-Tracker may provide new approach, improving maternal care for this at-risk population. Additionally, it allows expedited OSA management with longitudinal guidance to assess treatment modifications, necessary in a evolving medical scenario such as the third-trimester of pregnancy. Furthermore, this approach will allow insight into the pathophysiologic relationships between OSA and conditions such as gestational diabetes and hypertension. Support (if any) Research-supported-NIH#R43HL166038