How Does Sickle Cell Disease Affect Pregnant Women?

The rate of pregnancy complications, such as cesarean delivery and preeclampsia, is greater in patients with SCD compared with patients who have sickle cell trait (SCD trait), study findings presented at the 65th ASH Annual Meeting & Exposition showed. However, low birth weight and gestational diabetes mellitus (GDM) are more prevalent in patients with SCD trait.

Investigators from the University of Missouri at Kansas City retrospectively reviewed nearly 30,000 patient encounters that were collected from the Health Facts database.

The following SCD genotypes were included in the study: hemoglobin SS, hemoglobin S beta 0 thalassemia, hemoglobin S beta + thalassemia and hemoglobin SC disease, and SCD trait-hemoglobin AS.

Data showed that patients with SCD have higher percentages for rate of cesarian delivery (76.43% vs 13.76%) and preeclampsia (75.92% vs 5.43%) compared with patients with SCD trait.

Moreover, cerebrovascular accident, sepsis and septic shock, and VOC incidence were also greater in patients with SCD versus those with SCD trait.

A quarter of patients (25.00%) with SCD trait had asymptomatic bacteriuria compared with 0.08% in SCD patients. Urinary tract infection rates were also higher in patients with SCD trait (0.02%) compared with patients with SCD (0.00%).

Pregnancy complications, such as GDM, low birth weight, and preterm birth, were elevated in the SCD trait group compared with the SCD group. Specifically, GDM was 3.09% in SCD trait patients compared with 0.00% in SCD patients. In SCD trait patients, there was a 0.61% low birth weight rate versus 0.17% in SCD patients. Finally, preterm birth rates were 0.78% and 0.44% in SCD trait and SCD patients, respectively.

Reference

Alawode E, Mohamed Y, Suman S, et al. Incidence of maternal and perinatal morbidity in sickle cell disease and sickle cell trait patients during pregnancy. Abstract #3898. Presented at the 65th American Society of Hematology Annual Meeting & Exposition; December 9-12; San Diego, California.