Sickle cell disease and pregnancy: analysis of 34 patients followed at the Regional Blood Center of Ribeirão Preto, Brazil

Silva-Pinto, Ana Cristina; Ladeira, Simery de Oliveira Domingues; Brunetta, Denise Menezes; Santis, Gil Cunha De; Ângulo, Ivan L.; Covas, Dimas Tadeu

doi:10.1016/j.bjhh.2014.07.002

Cited by 30 publications

(44 citation statements)

References 15 publications

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“…12,19,22,23 Pinto S et al has reported vasoocclusive crisis in 61.7% of pregnant SCD patients and acute chest syndrome as high as 29.4%. 15 However, about 18.05% of vaso occlusive crisis and 5.56% of acute chest syndrome were observed in this study, which is consistent with an observational study in French Guiana where SCD has an incidence of 1 in 235 births. 10 Infective complications observed in this study were mainly urinary tract infections and pneumonia which were controlled without further complications.…”

Section: Discussionsupporting

confidence: 92%

“…9,15 Similar to many other studies, we found that obstetric complications like preeclampsia and gestational hypertension were high in women with sickle cell disease with a higher risk in homozygous (HbSS) genotype. [9][10][11][15][16][17][18][19] Eclampsia which is a life threatening complication of preeclampsia was reported to be 10 times high in HbSS women. 17 This study also showed a higher incidence of eclampsia in consistent with an earlier metaanalysis and also reports from other states of India.…”

Section: Discussionsupporting

confidence: 88%

“…But, unlike reported earlier, GDM and was comparable with normal population. 15,17 As previously reported, present study showed a 100% incidence of moderate to severe anemia in HbSS antenatal women; while there were studies with anemia as less as 8.4%. 9,22,17 But we found anemia in only 46.88% of HbAS women as against the 95% in earlier reports.…”

Section: Discussionsupporting

confidence: 81%

“…10,15 Pregnancy in sickle cell women is at high risk for maternal and fetal complications than in general population. 9,15 Similar to many other studies, we found that obstetric complications like preeclampsia and gestational hypertension were high in women with sickle cell disease with a higher risk in homozygous (HbSS) genotype. [9][10][11][15][16][17][18][19] Eclampsia which is a life threatening complication of preeclampsia was reported to be 10 times high in HbSS women.…”

Section: Discussionmentioning

confidence: 99%

“…12,22,24 Women with sickle cell hemoglobinopathy have been found to have a higher risk for preterm delivery. [9][10][11][12][15][16][17]20,21 According to Desai G et al and Ugobama et al, the incidence of preterm birth was as high as 44-45%. 12,20 Our incidence was 18.06% which was consistent with the 2-fold increased risk in SCD women.…”

Section: Discussionmentioning

confidence: 99%

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Fetomaternal outcome in sickle cell hemoglobinopathy in a tertiary care centre of North Kerala, India

D’Couth

Kalam

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Pregnancy is a serious burden to women with sickle cell disease (SCD). Our centre is the only tertiary care referral centre in the public sector which caters to the districts of Wayanad and the Nilgiris which has the maximum prevalence for SCD in South India. Hence this study was conducted to assess complications in pregnancy and maternal and perinatal outcome among women with SCD.Methods: A retrospective observational study was conducted by reviewing the medical records of all the pregnant women with SCD who had delivered in the Department of Obstetrics and Gynecology, Government Medical College, Kozhikode from January 2014 to December 2016.Results: There were 72 antenatal women with SCD during the study period with a prevalence of 0.15%. 54.17% (n = 39) patients were HbSS (sickle cell anemia), 44.44% (n = 32) were HbAS (sickle cell trait) and 1.39% (n = 1) were HbS-β thalassemia trait. There was increased risk of obstetric complications like gestational hypertension (16%), preeclampsia (11.11%), eclampsia (5.56%), HELLP syndrome (4.16%), intrauterine growth retardation (38.89%), and oligohydramnios (18.06%). Medical complications observed were mainly anaemia (76.38%), vasoocclusive crisis (18.05%), acute chest syndrome (5.56%) and infections like urinary tract infection (8.33%) and pneumonia (5.56%). The incidence of low birth weight babies (56.94%), low Apgar score (14.49%) and neonatal ICU admissions (31.88%) were high. There was no maternal mortality, but perinatal mortality was high (6.94%).Conclusion: Pregnancy in SCD is associated with an increased maternal morbidity and high perinatal mortality due to obstetric and medical complications.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Fetomaternal outcome in sickle cell hemoglobinopathy in a tertiary care centre of North Kerala, India

D’Couth

Kalam

2017

Int J Reprod Contracept Obstet Gynecol

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Abnormal expression of inflammatory genes in placentas of women with sickle cell anemia and sickle hemoglobin C disease

et al. 2016

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Sickle cell disease (SCD) is a complex disease that is characterized by the polymerization of deoxyhemoglobin S, altered red blood cell membrane biology, endothelial activation, hemolysis, a procoagulant state, acute and chronic inflammation, and vaso-occlusion. Among the physiological changes that occur during pregnancy, oxygen is consumed by fetal growth, and pregnant women with SCD are more frequently exposed to low oxygen levels. This might lead to red blood cells sickling, and, consequently, to vaso-occlusion. The mechanisms by which SCD affects placental physiology are largely unknown, and chronic inflammation might be involved in this process. This study aimed to evaluate the gene expression profile of inflammatory response mediators in the placentas of pregnant women with sickle cell cell anemia (HbSS) and hemoglobinopathy SC (HbSC). Our results show differences in a number of these genes. For the HbSS group, when compared to the control group, the following genes showed differential expression: IL1RAP (2.76-fold), BCL6 (4.49-fold), CXCL10 (-2.12-fold), CXCR1 (-3.66-fold), and C3 (-2.0-fold). On the other hand, the HbSC group presented differential expressions of the following genes, when compared to the control group: IL1RAP (4.33-fold), CXCL1 (3.05-fold), BCL6 (4.13-fold), CXCL10 (-3.32-fold), C3 (-2.0-fold), and TLR3 (2.38-fold). Taken together, these data strongly suggest a differential expression of several inflammatory genes in both SCD (HbSS and HbSC), indicating that the placenta might become an environment with hypoxia, and increased inflammation, which could lead to improper placental development.

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Long-term pediatric hematological morbidity of the early-term newborn

et al. 2018

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Children born at early term (37 0/7 to 38 6/7 weeks' gestation) are at an increased risk for long-term respiratory, cardiovascular, neurological, and developmental morbidities as compared with children born at full term (39 0/7 to 40 6/7 weeks' gestation). In this population-based cohort analysis, we sought to evaluate the long-term hematological morbidity of early-term born children. The cohort consisted of 223,242 term singleton deliveries. Hospitalizations of the offspring up to 18 years of age involving hematological morbidity were evaluated, including hereditary and acquired anemias, immunodeficiency disorders, coagulation disorders, white blood cell disorders, cytopenias, polycythemia, and myelodysplastic syndrome. Hematological hospitalizations were significantly more common in children delivered at early term as compared with those born at later gestational ages. A Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of hematological-related hospitalizations in the early-term born group (logrank p < 0.001). Using a Cox regression model, early-term delivery was found to be an independent risk factor for childhood hematological morbidity with an adjusted hazard ratio of 1.15 (95%CI 1.01-1.30, p=0.027).Conclusion: Early-term delivery appears to be independently associated with pediatric long-term hematological morbidity of the offspring. What is Known? • It has been shown that children born at early term are at increased risk for short-term adverse outcomes including perinatal mortality. • Early-term infants are also at increased risk for long-term morbidity, mainly respiratory. What is New? • Early-term delivery is also independently associated with long-term hematological morbidity of the offspring.

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Sickle cell disease and pregnancy: analysis of 34 patients followed at the Regional Blood Center of Ribeirão Preto, Brazil

Cited by 30 publications

References 15 publications

Fetomaternal outcome in sickle cell hemoglobinopathy in a tertiary care centre of North Kerala, India

Fetomaternal outcome in sickle cell hemoglobinopathy in a tertiary care centre of North Kerala, India

Abnormal expression of inflammatory genes in placentas of women with sickle cell anemia and sickle hemoglobin C disease

Long-term pediatric hematological morbidity of the early-term newborn

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