Original Article

Maternal/Perinatal Outcome in Women with Sickle Cell Disease: A Comparison of Two Time Periods

Authors: John N. Chang, MD, Everett F. Magann, MD, Sarah A. Novotny, MD, Chad E. Cooley, MD, C. Heath Gauss, MS, Marc R. Parrish, MD, John C. Morrison, MD

Abstract

Objective: To compare pregnancy outcomes in women with sickle cell disease from recent deliveries with a similar group delivered earlier.

Methods: During a 12-year period (2005–2016), data from pregnant women with hemoglobin SS or SC were collected from three university medical centers and compared with earlier studies (1979–2003) involving similar patients. The primary endpoints were maternal complications during pregnancy and newborn outcomes.

Results: There were 278 patients in the control group (1979–2003) compared with 150 patients in the study group (2005–2016). Women in the study group were older (P < 0.0001) and of less parity (P =0.0001), and complications of preterm delivery, preeclampsia, and having a transfusion were similar between the two groups (P = 0.45, 0.95, and 0.49, respectively). Pain crises were more common in the study group (P = 0.02) as was cesarean section (P < 0.0001), but there was a reduction in pulmonary complications (P = 0.0002). Maternal mortality was uncommon (control group [N=4] vs study group [N=3], P = 0.40). Newborn statistics revealed a similar gestational age at delivery (37 weeks), and the incidence of intrauterine growth restriction, as well as 5-minute Apgar score <7 did not differ by group (P = 0. 91, 0.85, and 0.16, respectively). Infants in the study group were heavier on average by approximately 220 g (P = 0.02), whereas the neonatal death rate was low (control group [N=1], study group [N=2] P = 0.60).

Conclusions: Recent pregnancy outcome statistics in women with sickle cell disease have not changed through the years. Innovative strategies to improve maternal and newborn outcomes among such patients are needed.

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