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ORIGINAL RESEARCH ARTICLE

Causal relationships between obstructive sleep apnea and pre-eclampsia: A Mendelian randomization study

Jinhua Ouyang1 ,  Mingqian Chen1 ,  Ke Yi1,2*
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1 Department of Obstetrics and Gynecology, Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases/Hubei Provincial Clinical Research Center for Nephrology, Minda Hospital of Hubei Minzu University, Hubei Minzu University, Enshi, Hubei, China
2 Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
EJMO, 025260274 https://doi.org/10.36922/EJMO025260274
Received: 24 June 2025 | Revised: 16 July 2025 | Accepted: 1 August 2025 | Published online: 2 September 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Previous observational investigations have revealed a possible association between obstructive sleep apnea (OSA) and pre-eclampsia (PE), but they are limited by confounding factors.

Objective: We employed genetic data in a two-sample Mendelian randomization (MR) study to investigate the causal link between PE and OSA.

Methods: To assess the causal influences of OSA and PE, this MR investigation used single-nucleotide polymorphisms (SNPs) as instrumental variables. The FinnGen database provided the genetic information for OSA, which included 50,200 cases and 401,484 controls, whereas data for PE were sourced from a study with 1728 cases and 192,399 controls. Sensitivity analyses were performed to check for pleiotropy and heterogeneity, and reverse MR was carried out to analyze potential bidirectional relationships.

Results: OSA and an elevated PE risk were found to be significantly correlated by the inverse variance weighted analysis (odds ratio [OR] [95% confidence interval (CI)] = 1.640 [1.166–2.306]; p=0.004). Sensitivity analyses revealed no heterogeneity or pleiotropy, as verified by MR-Egger intercept analysis and Cochran’s Q test. Leave-one-out analysis showed that no individual SNP drove the results. Evidence of a causal connection between PE and OSA was not found by reverse MR analysis (OR [95% CI] = 0.970 [0.927–1.015]; p=0.194).

Conclusion: This MR investigation points to a genetically supported causal link between higher PE risk and OSA.

Keywords
Obstructive sleep apnea
Mendelian randomization
Pre-eclampsia
Instrumental variable
Single nucleotide polymorphism
Funding
None.
Conflict of interest
The authors declare that they have no conflicts of interest.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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