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Abstract
Objective: To compare obstetrical, hematological and neonatal outcomes of pregnant women with or without sickle cell disease (SCD).
Methods: A prospective study of 60 pregnancies of 58 women with SCD (29 SCD-SS and 29 SCD-SC) compared with 192 pregnancies in 187 healthy pregnant women was carried out from January 2009 to August 2011.
Results: Compared to controls, the SCD group had higher rate of preterm delivery (p < 0.001, OR = 4.96, 95% CI 2.57–9.59), higher cesarean rate (p < 0.001, OR = 5.00, CI 2.65–9.45), more frequent deep vein thrombosis (p = 0.003), and urinary infection (p = 0.001, OR = 3.31, CI 1.63–6.73), higher prevalence of small for gestational age babies (p = 0.019, OR = 2.66, CI 1.15–6.17), and more frequent baby admissions to progressive care unit (p < 0.001, OR = 4.89, CI 2.26–10.6). Maternal death rate was also higher among women with SCD (p = 0.056). All adverse events were more frequent in the SS subgroup. Babies from the SS subgroup had the lowest weight at birth (2080 g) compared to SC (2737 g; p < 0.001) and controls (3035 g). A multivariate analysis confirmed painful episodes and SS genotype as factors contributing to preterm delivery.
Conclusion: SCD pregnant women – especially those in the SS subgroup – are more prone to experience perinatal and maternal complications in comparison with pregnant women without SCD.
Acknowlegements
Our thanks to all members of Project Aninha, in special to Milza Januario, MD, José Nelio Januario, MD, and Patricia Resende Cardoso, MD; to English translator Kelen Lima, and to Professor Kwaku Ohene-Frempong for his kind revision of the article.
Declaration of interest
This study was financially supported by the Ministry of Health, Project Aninha. The authors report no conflicts of interest.