Related Experiment Videos
The influence of infant and maternal sickle cell disease on birth outcome and neonatal course
A K Brown1, L A Sleeper, C H Pegelow
1Department of Pediatrics, State University of New York Health Science Center at Brooklyn.
Insights
Maternal sickle cell anemia increases the risk of adverse birth outcomes in infants with sickle cell disease (SCD). Infant hemoglobin type does not impact outcomes, but maternal health is a significant factor in neonatal complications.
Area of Science:
- Hematology
- Neonatology
- Obstetrics
- Genetics
Background:
- Sickle cell disease (SCD) is a genetic blood disorder that can affect pregnancy outcomes.
- Understanding the influence of maternal and infant hemoglobin phenotypes on birth outcomes is crucial for managing SCD pregnancies.
- Previous research has not fully elucidated the specific risks associated with maternal hemoglobinopathies in infants with SCD.
Purpose of the Study:
- To compare the impact of maternal and infant hemoglobin phenotypes on birth outcomes and neonatal complications in infants with sickle cell disease (SCD).
- To identify specific risk factors for adverse birth outcomes and neonatal complications in newborns with SCD.
Main Methods:
- A prospective, natural history study with retrospective chart review was conducted.
- Data were collected from 480 infants with SCD and 118 infants with sickle cell trait across 19 pediatric sickle cell centers in the United States.
- Infants were enrolled at less than 6 months of age.
Main Results:
- Infant hemoglobin phenotype did not significantly influence birth outcomes or neonatal complications in the SCD cohort.
- Infants born to mothers with sickle cell anemia had significantly higher rates of small-for-gestational age births (2.5 times more likely) and neonatal jaundice (P < .0001).
- Adverse birth outcomes in infants with SCD were comparable to normal infants, with preterm birth contributing less to low birth weight compared to US black newborns.
Conclusions:
- Maternal hemoglobin phenotype, particularly sickle cell anemia, is a significant risk factor for adverse birth outcomes and neonatal complications in infants with SCD.
- Infant hemoglobin phenotype does not appear to influence birth outcomes or neonatal course in infants with SCD.
- These findings highlight the importance of maternal health status in managing pregnancies involving sickle cell disease.
Objective:
To compare the influence of maternal hemoglobin phenotype as well as that of the infant on birth outcome and neonatal complications.
Research Design:
Prospective, natural history study with retrospective chart review for neonatal complications.
Setting:
Nineteen pediatric sickle cell centers across the United States.
Patients:
Four hundred eighty infants with sickle cell disease (SCD) who were enrolled in the Cooperative Study of Sickle Cell Disease at less than 6 months of age, as well as a comparison cohort of 118 infants with sickle cell trait born to women with sickle cell anemia in the Cooperative Study.
Results:
In the SCD cohort, overall rates of preterm (< 37 weeks), low-birth-weight (< 2500 g), and small-for-gestational age births were 9%, 10%, and 8%, respectively; no significant differences were found according to infant hemoglobin phenotype. Term births accounted for 59% of the infants with low birth weight, significantly higher than the 41% US rate for black low-birth-weight infants (P = .014). Expectant mothers with sickle cell anemia are 2.5 times more likely to bear newborns who are small for gestational age than are women with other types of sickle cell disease, sickle trait, or C-trait. The most common prepartum and neonatal complications in infants with SCD were jaundice (25%), fetal distress (13%), anemia (10%), and respiratory distress (6%). Complication rates did not differ significantly by hemoglobin phenotype in the infants with SCD, but infants born to women with sickle cell anemia had higher rates of jaundice (P < .0001).
Conclusions:
Rates of adverse birth outcomes and neonatal complications in infants with SCD are similar to the rates for normal infants, although preterm birth accounts for fewer of the low-birth-weight outcomes among newborns with SCD relative to US black newborns. The hemoglobin phenotype of infants with SCD does not influence birth outcome and neonatal course, but infants born to women with sickle cell anemia are at greater risk of preterm birth, low birth weight, being small for gestational age, and neonatal jaundice.