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Adverse clinical and obstetric outcomes among pregnant women with different sickle cell disease genotypes
Author(s) -
Silva Flávia A.C.,
Ferreira Ana L.C.G.,
HazinCosta Manuela F.,
Dias Marina L.G.,
Araújo Aderson S.,
Souza Ariani I.
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12626
Subject(s) - medicine , genotype , thalassemia , acute chest syndrome , abortion , adverse effect , obstetrics , pregnancy , blood transfusion , pediatrics , anemia , disease , sickle cell anemia , biochemistry , genetics , biology , gene , chemistry
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.