Adverse clinical and obstetric outcomes among pregnant women with different sickle cell disease genotypes

Objective To compare clinical and obstetric adverse events among pregnant women with sickle cell disease ( SCD ) according to genotype. Methods The present cross‐sectional study enrolled women aged 15–49 years with SCD and prior pregnancy attending a hematology center in Recife, Brazil, between September 1, 2015, and April 30, 2016. Associations between sickle cell genotype (Hb SS , Hb SC , Sβ‐thalassemia) and adverse events were evaluated. Results Overall, 89 women were included; 74 (83%) had Hb SS genotype, 8 (9%) had Hb SC genotype, and 7 (8%) had Sβ‐thalassemia genotype. Fifty‐three (60%) self‐reported being of mixed race, and 27 (30%) self‐reported they were black. Blood transfusion was observed more frequently among women with Hb SS than among those with Hb SC genotype ( P =0.007). Postpartum adverse events were more frequent in the Sβ‐thalassemia than in the Hb SS group ( P =0.030). Fetal intrauterine death occurred only among women with the Hb SS genotype (11 [15%]). In the Hb SS group, there was a higher frequency of blood transfusion ( P =0.004) and lower rate of spontaneous abortion ( P =0.001) among women with six or more consultations. Conclusion The Hb SS genotype was associated with a higher frequency of blood transfusion. Sβ‐thalassemia was associated with a higher frequency of postpartum adverse events. Prenatal care was associated with a lower rate of spontaneous abortion in the Hb SS group.