Postpartum Maternal Vascular Function in a Rat Model of Gestational Obstructive Sleep Apnea
Authors: Singhal Juhi , Osikoya Oluwatobiloba , Wilson Elizabeth Nicole , Mabry Steve , Cushen Spencer C. , Cunningham Rebecca L. , Goulopoulou Styliani 
Published: April 2020

IntroductionDe novo obstructive sleep apnea (OSA) in pregnancy, is associated with adverse gestational outcomes such as preeclampsia, gestational diabetes, and fetoplacental hypoxia. In addition, exposure to chronic intermittent hypoxia (CIH), a model of OSA, induces endothelial dysfunction and enhanced vasoconstriction in pregnant mice. It is currently unknown whether gestational OSA has a long‐term effect on maternal vascular function. We hypothesized that exposure to gestational CIH during late pregnancy will result in postpartum maternal vascular dysfunction.MethodsTimed pregnant female Long‐Evans rats were randomly assigned to two experimental groups: Normoxia (n=6) and CIH (n=6). The CIH group was exposed to five days (gestational days: 15–20) of intermittent hypoxia [6 min cycles of 3 min hypoxia (10% O2) and 3 min normoxia (21% O2)]. Gestational age at delivery was recorded and neonate’s crown‐rump length, abdominal girth, and body weights were measured within 12–16 hours from birth. At weaning (postnatal day 28), dams were euthanized and third‐order mesenteric arteries, and the main uterine artery, and uterine perivascular adipose tissue (PVAT) were excised. To assess endothelium‐dependent relaxation, we performed concentration‐response curves to acetylcholine (ACh: 10−9 – 3×10−5 M) using wire myography. In uterine arteries, we measured responses to ACh in the presence and absence of PVAT (0.1 g) based on our previous findings that uterine PVAT has vasoactive effects on these arteries.ResultsGestational CIH had no effect on the duration of gestation (Normoxia: 22.3 ± 0.21 days vs. CIH: 22.8 ± 1.16 days, p=0.24), litter size (Normoxia: 12.2 ± 1.64 vs. CIH: 10.3 ± 1.40, p=0.34), and neonatal weight at birth (Normoxia: 6.4 ± 0.24 g vs. CIH: 6.7 ± 0.19 g, p=0.16), while it increased neonatal crown‐rump length (Normoxia: 3.98 ± 0.07 cm vs. CIH: 4.19 ± 0.07 cm, p=0.05) and abdominal girth (Normoxia: 4.72 ± 0.10 cm vs. 4.94 ± 0.03 cm, p=0.07). At weaning, dams exposed to gestational CIH were lighter compared to dams exposed to normoxia (Normoxia: 319 ± 6.5 g vs. CIH: 298 ± 8.7 g, p=0.08). Exposure to gestational CIH had no effect on ACh‐induced relaxation in mesenteric resistance arteries (pEC50, Normoxia: 7.80 ± 0.03 vs. CIH: 7.89 ± 0.06, p=0.19). In the absence of PVAT, uterine arteries from dams exposed to gestational CIH had exaggerated responses to ACh compared to dams exposed to normoxia [(−)PVAT/pEC50, Normoxia: 6.77 ± 0.08 vs. CIH: 7.13 ± 0.09, p<0.01], while PVAT normalized this difference [(+)PVAT/pEC50, Normoxia: 6.67 ± 0.08 vs. CIH: 6.70 ± 0.07, p=0.99]. The effects of PVAT were due to its anti‐dilatory influences on uterine arteries from CIH‐treated rats [CIH (−PVAT) vs. CIH (+PVAT), p = 0.003], whereas it had no effect on arteries from control rats [Normoxia (−PVAT) vs. Normoxia (+PVAT), p = 0.77].ConclusionExposure to CIH during gestation resulted in neonatal macrosomia, reduced maternal weight at weaning, and exaggerated postpartum uterine vascular smooth muscle relaxation responses, while it did not affect small resistance artery reactivity. Gestational OSA may impair maternal vascular recovery after birth.Support or Funding InformationUNTHSC Basic Seed Grant