Maternal morbidity and mortality associated with mode of delivery in sickle cell disease

Martinborough, Tracey; Allen-Davis, W; Hunter-Greaves, Tiffany; Thame, M; Reid, Marvin; Simms-Stewart, Donnette

doi:10.1080/01443615.2022.2158314

Journal of Obstetrics and Gynaecology

2022

DOI: 10.1080/01443615.2022.2158314

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Maternal morbidity and mortality associated with mode of delivery in sickle cell disease

Tracey Martinborough

W Allen-Davis

Tiffany Hunter-Greaves

et al.

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2024

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Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?

Gibson,

Hunter,

Charles

et al. 2024

Journal of Perinatal Medicine

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Objectives Sickle cell disease (SCD) occurs in 2.8 % of our Jamaican antenatal population with homozygous HbSS being most associated with adverse maternal and perinatal outcomes. Methods A retrospective comparative analysis of HbSS, HbSC and HbSβThal pregnancy outcomes at the University Hospital of the West Indies (UHWI) between January 2012 and December 2022 was conducted. Results Of 120 patients (138 pregnancies), obesity occurred in 36 % (20/56) of the ‘non-HbSS’ group, i.e. HbSβThal (55 %, 5/9) and HbSC (32 %, 15/47) combined vs. 9.7 % of the HbSS (8/82). HbSS patients had more crises requiring transfusions, acute chest syndrome (ACS), maternal ‘near-misses’ (OR=10.7, 95 % 3.5–32.3; p<0.001), hospitalizations (OR 7.6, 95 % CI 3.4–16.9; p<0.001), low birth weight (LBW) neonates (OR 3.1, 1.1–8.9; p=0.037) and preterm birth (OR=2.6, 1.2–5.8; p=0.018) compared to HbSC and HbSβThal. Low dose aspirin was prescribed in 43 %. Logistic regression showed those NOT on aspirin (n=76) had more miscarriages (22 v. 2 %), were LESS likely to have a live birth (75 v. 95 % (0.2, 0.04–0.57, p=0.005)), but surprisingly had fewer painful crises (28 v. 46 % (0.5, 0.03–0.9, p=0.03)). Conclusions HbSS women had a 10-fold excess of maternal near-misses. Additional research may further clarify the effects of aspirin on pregnancy outcomes as related to SCD genotypes.

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Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?

Gibson,

Hunter,

Charles

et al. 2024

Journal of Perinatal Medicine

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Maternal morbidity and mortality associated with mode of delivery in sickle cell disease

Cited by 1 publication

References 28 publications

Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?

Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?

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