Sickle cell anemia/sickle cell disease and pregnancy outcomes among ethnic tribes in India: an integrative mini-review

Abstract

Objective: To evaluate the studies which have reported the prevalence of maternal complications and outcomes for women with SCA/SCD. Healthy populations make a healthy community and improve the future for mankind. Pregnant women are an essential segment of humanity as they bear the fetus and supply nutrition for their development throughout the gestational period. Their health status and disease conditions also play a vital role in deciding the future of the offspring.

Materials and methods: The Mesh terms: “Haemoglobinopathies” + “Sickle cell anemia” + “Sickle cell disease” + “Ethnic tribes” + “Pregnancy outcomes” + “India” were used to search the literature available from public databases such as “PubMed”, “PubMed Central” “Google Scholar”, “Science Direct” and “Scopus” and the same is checked for removing repetitions. The data was extracted and collected literature was thoroughly analysed. SCD/SCA is a commonly prevalent hereditary hemoglobinopathy disease and is related to augmented risk factors and premature mortality.

Results: SCD severely affects pregnancy, which leads to the elevated occurrence of perinatal and maternal outcomes such as pre-eclampsia, eclampsia, abortions, intrauterine growth retardation (IUGR), etc., and sufficient care during the pregnancy guarantees an improved outcome. Due to the best health care conveniences, availability of drugs such as hydroxyurea, antibiotic prophylaxis, and vaccination, the life expectancy of SCD patients has greatly improved in recent times though directly related to the access and services available at the healthcare facilities for the needy and poor. Moreover, the latest innovations in the fields of prenatal screening and preimplantation genetic diagnosis (PGD), facilitate partners suffering from SCA/SCD to have a healthy child. There are no available studies on the prevalence of SCA/SCD in pregnant women among ethnic tribal populations from India.

Conclusion: This review article is focused on the effects of SCA/SCD on pregnancy outcomes, the consistent follow-up, routine check-ups and successful management of complications throughout pregnancy, the various diagnostic methods toward preventive methods, curative and management therapeutic strategies and also defines the perinatal and maternal outcomes in the ethnic tribal populations of India.

Keywords:

• Haemoglobinopathies
• sickle cell disease (SCD)
• ethnic tribes
• pregnancy outcomes
• India

Authors’ contributions

BG and TR conceptualized the work; BG and TR performed the literature search and TR wrote the first draft of the manuscript. SKA and HK gave critical inputs. TR, BG, SKA and HK performed the editing of the manuscript and revisions by all the authors. The decision of the final version to be published was agreed upon by all the authors.

Acknowledgments

This review article is part of the ICMR Extramural research study (NIE/IHEC/201901-02) after obtaining necessary approvals from the Institutional Human Ethics Committee (IHEC) and Scientific Advisory Committee (SAC).

Disclosure statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

The corresponding author received funding from the ICMR Extramural Research grant for the study titled “Prevalence and severity of haemoglobin disorders (Haemoglobinopathies and G6Pd deficiency) and the measures of multi-morbidity and morbidity burden of selected hemoglobinopathies among tribal population of Tamil Nadu”. ICMR Extramural Research Grants No. Tribal/CFP/4/2018-ECD-II Dated 14/05/2019 .