Pregnancy outcome in patients with sickle cell disease in the UK – a national cohort study comparing sickle cell anaemia ( H b SS ) with H b SC disease

Summary We describe the findings from a national study of maternal and fetal outcomes of pregnancy in women with sickle cell disease ( SCD ). Data were collected via the U nited K ingdom O bstetric S urveillance S ystem between 1 F ebruary 2010 and 31 J anuary 2011 from 109 women, of whom 51 (46·8%) had H b SS and 44 (40·4%) had H b SC . Data included antenatal, maternal and fetal outcomes. Comparisons were made between women with H b SS and H b SC . Incidence of complications were acute pain (57%), blood transfusion (26%), urinary tract infection ( UTI ; 12%) and critical care unit admission (23%) and these were all more common in women with Hb SS than Hb SC . There was no difference in the incidence of acute chest syndrome, hypertension and venous thromboembolism between Hb SS and Hb SC . Women with Hb SS were more likely to deliver at <37 weeks gestation ( P  = 0·01) and their babies were more likely to have reduced birth weight. Delivery at <34 weeks was increased in both Hb SS and Hb SC women (5·9% vs. 4·6%) compared to national data. This study confirms a high rate of maternal and fetal complications in mothers with SCD , even in women with Hb SC , which has previously been considered to have a more benign phenotype in pregnancy.