Sickle Cell Disease during pregnancy Significant Risk Factor for Maternal-Fetal Morbidity, finds study

Among the 24,256 deliveries, 354 women (1.5%) had SCD, and 4216 women (17.4%) were identified as having the sickle cell trait.

Maternal Morbidity Risks:

• Women with SCD had a significantly higher risk as compared to normal pregnancies :

• Maternal death: AOR 13.7 (95% CI: 4.5-42.7).

• Anemia: AOR 6.8 (95% CI: 4.5-10.2).

• Severe anemia: AOR 4.3 (95% CI: 3.3-5.6).

• Preterm delivery: AOR 4.5 (95% CI: 3.6-5.7).

• Cesarean section: AOR 5.5 (95% CI: 4.7-7.0).

Fetal Outcomes:

• Stillbirth: AOR 3.4 (95% CI: 2.3-5.3).

• Low birth weight: AOR 3.1 (95% CI: 2.4-3.9).

Timing of Risk:

• The greatest risks of maternal morbidities were in the last month of gestation.

SCD Severity:

• Pregnant women with severe manifestations of SCD before conception were at increased risk for complications during pregnancy.

Maternal-fetal morbidities are increased by sickle cell disease, especially the risks of maternal death, anemia, preterm delivery, and poor fetal outcomes. This is a critical final month of gestation requiring high-level care for those women with SCD who had prior severe manifestations. This underscores the need for high-impact healthcare interventions.

Reference:

Dave K, Desai S, Desai T, Desai G. Adverse maternal and fetal outcomes among tribal pregnant women suffering from sickle cell disease: A retrospective cohort study in a community-based hospital situated in a tribal block of Gujarat, India. Int J Gynaecol Obstet. 2024 Nov 6. doi: 10.1002/ijgo.15999. Epub ahead of print. PMID: 39503239.