The Mechanisms of Low Birth Weight in Infants of Mothers With Homozygous Sickle Cell Disease

Thame, M; Lewis, Jillian; Trotman, H; Hambleton, Ian; Serjeant, G. R.

doi:10.1542/peds.2006-2768

Cited by 40 publications

(33 citation statements)

References 29 publications

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“…These physiological changes due to SCD may lead to complication and affect foetal growth during pregnancy [32]. There are no clear strategies to improve maternal outcomes for women with SCD in low resource settings [30].…”

Section: Discussionmentioning

confidence: 99%

Sickle cell disease and pregnancy outcomes: a study of the community-based hospital in a tribal block of Gujarat, India

Desai

Anand

Shah

et al. 2017

J Health Popul Nutr

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BackgroundSickle cell disease (SCD) is a hereditary blood disorder prevalent in tribal regions of India. SCD can increase complications during pregnancy and in turn negatively influence pregnancy outcomes. This study reports the analysis of tribal maternal admissions in the community-based hospital of SEWA Rural (Kasturba Maternity Hospital) in Jhagadia block, Gujarat. The objective of the study is to compare the pregnancy outcomes among SCD, sickle cell trait and non-SCD admissions. This study also estimated the risk of adverse pregnancy outcomes for SCD admissions.MethodsThe data pertains to four and half years from March 2011 to September 2015. The total tribal maternal admissions were 14640, out of which 10519 admissions were deliveries. The admissions were classified as sickle cell disease, sickle cell trait and non-sickle cell disease. The selected pregnancy outcomes and maternal complications were abortion, stillbirth, Caesarean section, haemoglobin levels, blood transfusion, preterm pregnancy, newborn birth weight and other diagnosed morbidities (IUGR, PIH, eclampsia, preterm labour pain). The odds ratios for each risk factor were estimated for sickle cell patients. The odds ratios were adjusted for the respective years.ResultsOverall, 1.2% (131 out of 10519) of tribal delivery admissions was sickle cell admissions. Another 15.6% (1645 out of 10519) of tribal delivery admissions have sickle cell trait. The percentage of stillbirth was 9.9% among sickle cell delivery admission compared to 4.2% among non-sickle cell deliveries admissions. Among sickle cell deliveries, 70.2% were low birth weight compared to 43.8% of non-sickle cell patient. Similarly, almost half of the sickle cell deliveries needed the blood transfusion. The 45.0% of sickle cell delivery admissions were pre-term births, compared to 17.3% in non-SCD deliveries. The odds ratio of severe anaemia, stillbirth, blood transfusion, Caesarean section, and low birth weight was significantly higher for sickle cell admissions compared to non-sickle cell admissions.ConclusionsThe study exhibited that there is a high risk of adverse pregnancy outcomes for women with SCD. It may also be associated with the poor maternal and neonatal health in these tribal regions. Thus, the study advocates the need for better management of SCD in tribal Gujarat.

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Section: Discussionmentioning

confidence: 99%

Sickle cell disease and pregnancy outcomes: a study of the community-based hospital in a tribal block of Gujarat, India

Desai

Anand

Shah

et al. 2017

J Health Popul Nutr

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“…Although the etiology of fetal growth restriction can be heterogeneous, 36 the most likely process in the context of SCD is placental insufficiency, which is supported by the recognition of a strong relationship between placental weight and birth weight for infants of mothers with homozygous SCD, 37 and by reports of pathologic placental features consisting of calcifications, infarcts, intervillous hemorrhage, fibrin necrosis, and syncytial knots. 38 Placental dysfunction in this setting is likely a consequence of both vaso-occlusion and impaired placental development, 4,39 creating a condition of relative fetal hypoxia.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic transfusion for pregnant women with sickle cell disease: a systematic review and meta-analysis

Malinowski

Shehata

D’Souza

et al. 2015

Blood

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Key Points• Prophylactic transfusion in pregnant women with SCD may reduce maternal mortality, vaso-occlusive pain events, and pulmonary complications.• Prophylactic transfusion in pregnant women with SCD may similarly reduce perinatal mortality, neonatal death, and preterm birth.Pregnancy in women with sickle cell disease is associated with adverse maternal and neonatal outcomes. Studies assessing the effects of prophylactic red blood cell transfusions on these outcomes have drawn inconsistent conclusions. The objective of this systematic review was to assess the effect of prophylactic compared with on-demand red blood cell transfusions on maternal and neonatal outcomes in women with sickle cell disease. A systematic search of several medical literature databases was conducted. Twelve studies involving 1291 participants met inclusion criteria. , and preterm birth (9 studies, 1123 participants; OR, 0.59; 95% CI, 0.37-0.96). Event rates for most of the results were low. Prophylactic transfusions may positively impact several adverse maternal and neonatal outcomes in women with sickle cell disease; however, the evidence stems from a relatively small number of studies with methodologic limitations. A prospective, multicenter, randomized trial is needed to determine whether the potential benefits balance the risks of prophylactic transfusions. (Blood. 2015;126(21):2424-2435

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“…The characteristics of the 21 studies included in the meta-analysis are outlined in Table 2 (HbSS disease [12][13][14][15][16][17][18][19][20][21][22][23] ), Table 3 (HbSC disease 6,17,18,20,23 ), and Table 4 (SCD with genotype not specified). [24][25][26][27][28][29][30][31] All studies were categorized as pregnancy cohort studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis

Oteng‐Ntim

Meeks

Seed

et al. 2015

Blood

197

223

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Key Points• Pregnant women with sickle cell disease have high risks of adverse maternal and perinatal outcomes.• The risks are greatest for those with HbSS disease (vs HbSC disease) and those in low income (vs high income) countries.A systematic review and meta-analysis of observational studies were conducted to quantify the association between sickle cell disease in pregnancy and adverse maternal and perinatal outcomes. 32-5.98). Meta-regression demonstrated that genotype (HbSS vs HbSC), low gross national income, and high study quality were associated with increased RRs. Despite advances in the management of sickle cell disease, obstetrics, and neonatal medicine, pregnancies complicated by the disease remain associated with increased risk of adverse maternal and perinatal outcomes. (Blood. 2015;125(21):3316-3325)

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The Mechanisms of Low Birth Weight in Infants of Mothers With Homozygous Sickle Cell Disease

Cited by 40 publications

References 29 publications

Sickle cell disease and pregnancy outcomes: a study of the community-based hospital in a tribal block of Gujarat, India

Sickle cell disease and pregnancy outcomes: a study of the community-based hospital in a tribal block of Gujarat, India

Prophylactic transfusion for pregnant women with sickle cell disease: a systematic review and meta-analysis

Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis

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