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Perinatal outcomes in women with sickle cell disease: a matched cohort study from London, UK
Author(s) -
Oakley Laura L.,
Mitchell Sian,
von Rege Inez,
Hadebe Ruth,
Howard Jo,
Robinson Susan E.,
OtengNtim Eugene
Publication year - 2022
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.17983
Subject(s) - medicine , obstetrics , relative risk , pregnancy , eclampsia , cohort , caesarean section , gestational age , poisson regression , preeclampsia , confidence interval , cohort study , gestation , pediatrics , population , genetics , environmental health , biology
Summary There are limited data on contemporary outcomes for women with sickle cell disease (SCD) in pregnancy. We conducted a single‐site matched cohort study, comparing 131 pregnancies to women with SCD between 2007 and 2017 to a comparison group of 1310 pregnancies unaffected by SCD. Restricting our analysis to singleton pregnancies that reached 24 weeks of gestation, we used conditional Poisson regression to estimate adjusted risk ratios (aRRs) for perinatal outcomes. Infants born to mothers with SCD were more likely to be small for gestational age [aRR 1·69, 95% confidence interval (CI) 1·13–2·48], preterm (aRR 2·62, 95% CI 1·82–3·78) and require Neonatal Unit (NNU) admission (aRR 3·59, 95% CI 2·18–5·90). Pregnant women with SCD were at higher risk of pre‐eclampsia/eclampsia (aRR 3·53, 95% CI 2·00–6·24), more likely to receive induction of labour (aRR 2·50, 95% CI 1·82–1·76) and caesarean birth (aRR 1·44, 95% CI 1·18–1·76). In analysis stratified by genotype, the risk of adverse outcomes was highest in haemoglobin SS (HbSS) pregnancies ( n = 80). There was no strong evidence that haemoglobin SC (HbSC) pregnancies ( n = 46) were at higher risk of preterm birth, caesarean delivery, or NNU admission. Pre‐eclampsia/eclampsia was more frequently observed in HbSC pregnancies. Despite improvements in the care of pregnant women with SCD, the increased risk of adverse perinatal outcomes remains.