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Pregnancy Outcomes among Patients with Sickle Cell Disease in Brazzaville
F O Galiba Atipo Tsiba1,2, C Itoua2,3, C Ehourossika3
1Hematology Department, University Hospital of Brazzaville (Congo), Brazzaville, Congo.
Insights
Pregnancy in women with sickle cell disease (SCD) significantly increases risks for both mother and baby. Outcomes include higher rates of infection, cesarean delivery, prematurity, low birth weight, and neonatal death compared to women without SCD.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Genetics
Background:
- Sickle cell disease (SCD) is a prevalent global genetic disorder.
- SCD is characterized by chronic hemolytic anemia, vasoocclusive crises, and infection susceptibility.
- Pregnancy in women with SCD is associated with increased maternal and fetal complications.
Purpose of the Study:
- To compare pregnancy outcomes in women with SCD versus those without SCD.
- To assess maternal and perinatal morbidity and mortality in SCD pregnancies.
- To identify specific risks associated with SCD during gestation.
Main Methods:
- A case-control study was conducted in Brazzaville over two years (July 2017-June 2019).
- 65 pregnant women with homozygous SCD (SS) were compared to 130 non-SCD pregnant women.
- Data collected included mode of childbirth, maternal, and perinatal outcomes.
Main Results:
- SCD pregnancies had significantly higher risks of infection (29.3% vs. 4.6%), cesarean delivery (63% vs. 35.4%), and prematurity (75.4% vs. 30.8%).
- Infants born to mothers with SCD faced increased risks of low birth weight (52.3% vs. 16.1%), NICU admission (40.3% vs. 17.5%), and neonatal death (21.5% vs. 4.8%).
- Average gestational age at delivery was lower for SCD patients (35 weeks) compared to controls (38 weeks).
Conclusions:
- Pregnancy in women with homozygous sickle cell anemia presents a high-risk scenario.
- Both maternal and fetal outcomes are significantly compromised in SCD pregnancies.
- These findings underscore the need for specialized prenatal care for SCD patients.
Introduction:
Sickle cell disease (SCD) is one of the most common genetic diseases in the world. It combines, in its homozygous form, chronic hemolytic anemia, vasoocclusive complications, and susceptibility to infections. It is well known that the combination of pregnancy and sickle cell disease promotes the occurrence of complications that are sometimes fatal for the mother and/or the fetus.
Objective:
The objective of the current study was to compare pregnancy outcomes among women with SCD with those of women without the diagnosis of SCD. Materials and methods. It was a case-control study carried out in four maternity hospitals in Brazzaville in 2 years (July 2017-June 2019). It concerned 65 parturients with SS homozygous SCD. The mode of childbirth and maternal and perinatal morbidity and mortality were compared with those of 130 non-sickle cell pregnant women.
Results:
The average age was 27 years for SCD women and 31 years for non-SCD women. The average gestational age at delivery was 35 weeks for SCD women and 38 weeks for non-SCD women. From the logistic regression analysis using the comparison group as the reference group, there was excessive risk in SCD compared to non-SCD of infection (29.3% vs. 4.6%, OR = 21.7, 95% CI [7.6-62.7]; p=0.001), cesarean (63% vs. 35.4%, OR = 3.1, 95% CI [1.6-5.7]; p=0.001), prematurity (75.4% vs. 30.8%, OR = 8, 95% CI [3.0-23.2]; p=0.001), low birth weight (52.3% vs. 16.1%, OR = 4.7, 95% CI [2.4-9.4]; p=0.001), neonatal requiring admission to the intensive care unit (40.3% vs. 17.5%, OR = 3.2, 95% CI [1.6-6.3]; p=0.01), and neonatal death (21.5% vs. 4.8%, OR = 4.3, 95% CI [1.5-12.2]; p=0.01).
Conclusion:
The risk of pregnancy in patients with homozygous sickle cell anemia remains high, on both the maternal and fetal sides.
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History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...