Sickle Cell Disease and Pregnancy Outcomes

Barfield, Wanda D.; Barradas, Danielle T.; Manning, Susan E.; Kotelchuck, Milton; Shapiro-Mendoza, Carrie K.

doi:10.1016/j.amepre.2009.12.020

Cited by 74 publications

(86 citation statements)

References 25 publications

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“…The current study has showed that the incidence of adverse pregnancy outcomes was high among SCD deliveries with more than two thirds of all SCD deliveries ending in one or more adverse outcomes. This high incidence of adverse outcomes concurs with the findings by other international studies that generally report increased adverse pregnancy outcomes among SCD deliveries [5][6][7][8][9][10][11]13,[17][18][19]]. …”

Section: Discussionsupporting

confidence: 78%

“…Both these findings could be anticipated since our composite adverse pregnancy outcomes variable included low birth weight component. Low birth weight is the most consistent finding in studies that have addressed fetal outcomes in SCD [4][5][6][7][8][9][10]12,13,16,21,23]. Its persistence even in settings where SCD management in pregnancy has been standard shows how difficult it is to prevent.…”

Section: Discussionmentioning

confidence: 94%

“…A four-fold risk associated with Cesarean delivery as compared to vaginal delivery was also noted independent of other factors. Studies elsewhere report increased Cesarean delivery among SCD [8,[20][21] and the disease is not considered a contraindication for this mode of delivery. The increased risk for adverse pregnancy outcomes in the current study could be explained by the limited attention paid to anaesthetic selection with a preference of general anesthesia rather than regional analgesia in the study setting.…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly mentioned complications include spontaneous abortions, premature labor, fetal growth retardation, low birth weight, delivery by Caesarean section, infections, thromboembolic events, hypertensive disorders, hemorrhages and retained placenta [5][6][7][8][9][10][11][12][13]. Most studies seem to agree on increased adverse fetal outcomes but there is a wide discrepancy on the occurrence of maternal compli-…”

Section: Introductionmentioning

confidence: 99%

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Determinants of adverse pregnancy outcomes among Sickle Cell Disease deliveries at a tertiary hospital in Tanzania from 1999 to 2011

Muganyizi¹

2013

OJOG

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Purpose: Sub-Saharan Africa has the world's largest burden of Sickle Cell Disease (SCD), but due to poor care of SCD in childhood most do not reach reproductive ages. Consequently, due to sporadic cases of SCD in pregnancy, there has been little research attention to the problem in this sub region. This is one of the largest study series of SCD deliveries in Sub-Saharan Africa that aimed to establish the incidence and determinants of adverse pregnancy outcomes. Methods: Data of all deliveries from 1999 to 2011 at Muhimbili National Hospital (MNH) in Tanzania were analyzed. Deliveries of SCD were obtained and categorized according to presence or absence of adverse pregnancy outcomes based on set composite criteria. Using IBM SPSS statistics version 19, bivariate and multivariate logistic regression analyses were done to determine factors that were independently associated with adverse pregnancy outcomes. Statistics with p-value < 0.05 were taken as significant. Results: There were 157,473 deliveries during the study period of which 149 were by SCD mothers. The incidence of adverse pregnancy outcomes was 624 per 1000 SCD deliveries. Compared to SCD without adverse outcomes, those with adverse outcomes were more likely to be referred from lower health facilities (37% versus 12.5%, P = 0.001), of lower mean gestation age (36.3 ± 2.3 versus 38.4 ± 1.4, P < 0.001), more prematurity rate (50.7% versus 10.5%, P < 0.001), made lower mean number of antenatal visits (4.7 ± 2.2 versus 6.2 ± 2.4, P < 0.001) and delivered by cesarean section (31.2% versus 19.6%, P < 0.001). After adjusting for confounding factors, the odds of adverse outcomes were independently increased with referred compared to non-referred women (OR = 4.4; 95% CI: 1.2 -16.8) and among Cesarean section deliveries compared to vaginal deliveries (OR = 4.2; 95% CI: 1.2 -14.6). The risk of adverse outcomes decreased as the gestation age increased (OR = 0.4; 95% CI: 0.3 -0.6). Conclusion: The incidence of adverse pregnancy outcomes in SCD is unacceptably high mainly contributed by poor management and prematurity.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Determinants of adverse pregnancy outcomes among Sickle Cell Disease deliveries at a tertiary hospital in Tanzania from 1999 to 2011

Muganyizi¹

2013

OJOG

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“…Barfield et al conducted a retrospective cohort study of women of African descent who resided in Massachusetts with a live birth or fetal death recorded during 1998-2006 [9]. The authors reported that women with SCD had a higher prevalence of preeclampsia, lung disease, and heart disease during the antenatal, delivery or postpartum periods compared with women without hemoglobinopathies.…”

Section: Introductionmentioning

confidence: 99%

Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population

Boulet

Okoroh

Azonobi

et al. 2013

Matern Child Health J

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Higher frequencies of pregnancy complications have been reported among women with sickle cell disease (SCD) compared with those without SCD; however, past studies are limited by small sample size, narrow geographic area, and use of hospital discharge data. We compared the prevalence of maternal complications among intrapartum and postpartum women with SCD to those without SCD in a large, geographically diverse sample. Data from the 2004-2010 Truven Health MarketScan ® Multi-State Medicaid databases were used to assess the prevalence of maternal complications among intrapartum and postpartum women 15-44 years of age with and without SCD whose race was reported as black. The comparison group of women without SCD was further divided into those with chronic conditions associated with multi-organ failure and those without chronic conditions. Multivariable log-binomial regression models were used to calculate adjusted prevalence ratios for outcomes for women with SCD compared with women in the two comparison groups. Of the 335,348 black women with a delivery during 2004-2010, 1,526 had a diagnosis of SCD (0.5 %). Compared with women without SCD who had chronic conditions, women with SCD had higher prevalence of deep vein thrombosis, pulmonary HHS Public Access Author manuscriptMatern Child Health J. Author manuscript; available in PMC 2015 April 13. Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript embolism, obstetric shock, pneumonia, sepsis, postpartum infection, and transfusions. SCD was also positively associated with acute renal failure, cerebrovascular disorder, respiratory distress syndrome, eclampsia, postpartum hemorrhage, preterm birth, and ventilation when compared with women without SCD and chronic conditions. Overall, women with SCD have increased prevalence of pregnancy complications, even when compared with a group of women with similar risk for multi-organ failure.

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