Sleep Apnea in pregnant women may affect fetal growth

Dr. Yehuda Ginosaur

BY PATRICIA CORRIGAN, SPECIAL TO THE JEWISH LIGHT

Along with its obvious joys, pregnancy sometimes brings complications. Dr. Yehuda Ginosar has conducted research in Israel on some of those complications and now is at Washington University.

Ginosar will talk about his research at 7:15 p.m. Sept. 28 at the Jewish Community Center’s Arts and Education Building, 2 Millstone Campus Drive. His address, “From Jerusalem to St. Louis: My Journey in Pediatric and Obstetric Anesthesiology with Hadassah Hospital” is sponsored by Hadassah St. Louis. 

The event is open to the public. Advance reservations are appreciated. (Call 314-991-0434.) Admission is $18 in advance or $20 at the door, space permitting. 

Ginosar, 54, a fourth-generation physician, made time recently to talk about his work.

 

You are on an extended sabbatical from your job as director of the Mother and Child Anesthesia Unit at the Hadassah Medical Organization. What brought you to St. Louis?

Well, I was invited here, but I could not have dreamt of a better place.

 

Why is that? 

The two institutions share a similar culture of scientific medicine. In Hadassah, a revolving door connects the science laboratories on the one side with the hospital on the other. Clinicians go to the scientists for their expertise and scientists come to the hospital to understand the clinical context for their discoveries. 

 

And this physical proximity is useful? 

It is part of the reason why Hadassah and the Hebrew University together have written about half of all medical publications in Israel and have received about half of all national medical research funding. This culture of cross-talk is exactly what typifies Washington University, but in spades. 

 

Research was not your first area of specialization. What led you to it? 

I did my residency in anesthesia at Hadassah, and was most interested in clinical medicine and teaching. But it was clear that to develop a career there I would have to do research. 

 

What was your next move? 

I went to Stanford on a two-year research fellowship, which I loved. I came back to Hadassah and started looking at the use of epidural anesthesia as antenatal therapy,  to increase blood flow to the developing fetus in women with preeclampsia. 

 

Since then you’ve done studies tracking the effects of diminished CO2 levels on fetuses in pregnant mice. Talk a bit about that.

We looked at the oxygenation of blood and tissues in the placenta, the fetus and the fetal organs in pregnant mice, and we looked at how a fetus responds when the mother is not getting enough oxygen. We were surprised to see that carbon dioxide had a profound asphyxiating effect on the placenta and on the fetus in mice. 

 

Why is this significant? 

If the same phenomenon occurs in humans, that could be a big deal. People with obstructive sleep apnea snore so badly that they stop breathing every few minutes. Could that be a factor why some babies may not be growing properly? 

 

Is it? 

Right now we don’t know. Dr. Suzanne Karan at University of Rochester worked with me on this at Hadassah and we are now planning a multicenter study with Hadassah, Washington University and University of Rochester.  

 

Though about one-fifth of pregnant women may experience obstructive sleep apnea, they are rarely diagnosed or treated for it. Why not?

Few physicians diagnose it in pregnant women. The perception is that if the woman is snoring or is exhausted, that this is all part of being pregnant and will pass. 

 

You say one solution is to create a new diagnostic entity known as gestational sleep apnea. Why?

It is a bit like gestational diabetes or gestational hypertension — a transitory diagnosis of pregnancy. If there is a box to tick, then more women will be diagnosed and may get therapy.

 

Are you enjoying your time in St. Louis?

The Jewish community is beyond incredible. I attend services at Young Israel, and when I go to shul, members invite me over for meals. When I’m in Israel with my family, I get texts asking when I will be back. Everyone is very embracing.