Maternal and perinatal outcomes in pregnant women with sickle cell disease: an update

Sousa, Viviane Teixeira de; Ballas, Samir K.; Leite, Júlia Mota; Olivato, Maria Cristina Albe; Cançado, Rodolfo Delfini

doi:10.1016/j.htct.2020.12.009

Cited by 12 publications

(8 citation statements)

References 24 publications

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“…This study reports that pregnancy complications are more frequent in HbSS than other genotypes. These findings are matched with the reports of several studies ( 6 , 15 , 57 , 58 ). The outcomes of pregnancy in the HbSS genotype were worse than HbAA and HbAS.…”

Section: Discussionsupporting

confidence: 92%

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Pregnancy in the Sickle Cell Disease and Fetomaternal Outcomes in Different Sickle cell Genotypes: A Systematic Review and Meta- Analysis

Aghamolaei¹,

Pormehr-Yabandeh²,

Hosseini³

et al. 2022

Ethiop J Health Sci

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BACKGROUND: Pregnancy is a major concern among women with the sickle cell disease (SCD), and it is associated with increased adverse outcomes. The aim of the present meta-analysis is to report the fetomaternal outcomes in different sickle cell genotypes.METHODS: In this systematic review and meta-analysis, a comprehensive search of databases and search engines such as PubMed, Scopus, Web of Science, ProQuest, Cochrane Library, Science Direct and Google Scholar were performed. Any observational studies that had compared at least one outcome such as maternal outcomes, fetal outcomes, and morbidity between two groups of pregnant women with different types of sickle cell genotypes and pregnant women without SCD were evaluated.RESULTS: A total number of 9,827 pregnant women with SCD were examined. The results showed that pregnancy in SCD increased the risk of adverse outcomes for the mothers (including postpartum hemorrhage, prematurity, pregnancy-induced hypertension, pre-eclampsia, eclampsia, cesarean section, lower segment cesareansection, maternal death), fetus (including live births, low birth weight, intrauterine growth restriction, APGAR score at 5 min <7, stillbirth, neonatal death, perinatal mortality, acute fetal distress, intrauterine fetal death) and morbidity among the SCD(severe anemia, urinary tract infection, blood transfusion, painful crisis, acute chest syndrome, vaso-occlusive crises).CONCLUSION: According to the results of this meta-analysis, pregnancy in the SCD is associated with an increased risk of maternal outcomes, fetal outcomes, and morbidity among SCD patients with different genotypes. Pregnancy in sickle cell hemoglobinopathies needs careful multidisciplinary management and cautious caring so as to decrease maternal and fetal morbidity and mortality.

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Section: Discussionsupporting

confidence: 92%

“…Contrary to the existing developments in health care, especially in taking care of pregnant women over the past 4 decades, the maternal and fetal morbidity and mortality rate is high. The therapeutic interventions to improve pregnancy-related outcomes are restricted in women with SCD, particularly in those with the HbSS genotype ( 57 ).…”

Section: Discussionmentioning

confidence: 99%

Pregnancy in the Sickle Cell Disease and Fetomaternal Outcomes in Different Sickle cell Genotypes: A Systematic Review and Meta- Analysis

Aghamolaei¹,

Pormehr-Yabandeh²,

Hosseini³

et al. 2022

Ethiop J Health Sci

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“…Like perinatal mortality rates, stillbirth rates are variable from studies and constitute the burden of perinatal mortality in these pregnant women. On the other hand, authors in Brazil 20,30 reported lower stillbirths rates of 17‰ and 2.71‰ respectively. These low rates would be due to intensive follow-up of pregnant women.…”

Section: Discussionmentioning

confidence: 94%

“…According to many authors, the limit used was 28WA. 7,15,17,30 The risk of stillbirth is higher in pregnant women with sickle cell disease, [12][13][14][15]19 and these stillbirth rates, although variable depending on the country, remain high especially in countries with limited resources. Beyond the environmental and socio-economic factors, in term of physiology, pregnancy induces significant changes described above, causing chronic hypoxia and an unfavorable fetal prognosis.…”

Section: Discussionmentioning

confidence: 99%

Perinatal morbidity and mortality in neonates of mothers with sickle cell disease at the Teaching Hospital of Borgou /Alibori (Benin)-II

Agbeille,

Bagnan,

Noudamadjo

et al. 2023

JPNC

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Introduction: Pregnancy in women with sickle cell disease exposes the neonate to an increased risk of perinatal mortality. Objective: To determine perinatal morbidity and mortality in neonates of mothers with sickle cell disease at the teaching hospital of Borgou/Alibori in northen Benin. Patients and methods: This was a descriptive and observational study conducted in maternity and neonatology departments at the teaching hospital of Borgou/Alibori from January 1, 2015 to August 31, 2019. It included neonates of at least 22 weeks or weighing more than 500g, alive or not at birth from mothers with sickle cell disease. The variables studied were sociodemographic, clinical and evolutionary. The protocol was submitted to the ethics committee of the University of Parakou and obtained its approval under the reference 0289/CLERB-UP/P /SP/R/SA. Results: During the period, 130 pregnant women with sickle cell disease were admitted out of a total of 10,087, representing a frequency of 1.3%. The main perinatal morbidities were: acute fetal distress (10,4%), prematurity and intrauterine growth restriction (49.5%), respiratory distress (40%), bacterial infections (30.5%) and perinatal asphyxia (21.1%). Perinatal deaths occurred in 28 neonates and the perinatal mortality rate was 243.5‰. Conclusion: Acute fetal distress and low birth weight are the main perinatal morbidities observed. Perinatal mortality in these neonates is higher than in the general population in our context. Hence the need for early multi-disciplinary care.

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“…Pregnancy in women with SCD results in an increased incidence of maternal and perinatal complications, such as pre-eclampsia, preterm labour, intrauterine growth restriction (IUGR), and abortions ( Sousa et al 2022 ). Additionally, pregnancy aggravates the pre-existing anaemia in women with SCD, leading to an increased incidence of severe anaemia and frequent need for blood transfusion ( Smith-Whitley 2019 ).…”

Section: Pregnancy Complicationsmentioning

confidence: 99%

Impact of vitamin B12 on the reproductive health of women with sickle cell disease: a narrative review

Agbalalah

Robert

Amabebe

2023

Reproduction and Fertility

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Sickle cell disease (SCD) poses an increased risk of infertility, pregnancy complications and maternal and perinatal mortality among women of reproductive age. This risk is particularly higher for women in sub-Saharan Africa, where the disease burden is highest and access to comprehensive health care is limited, as well as in other countries with a high SCD prevalence due to migration. Disease modifying treatments for SCD could directly and indirectly harm the ovaries, potentially compromising quality and quantity of existing oocytes. Therefore, it is essential to explore alternative interventions, such as nutritional modifications that are less harmful and cost-effective in order to improve reproductive outcomes, and enhance the overall well-being of both mother and child in this population. Maintaining optimal levels of B12 may possibly provide benefits to the ovaries and pregnancy by decreasing homocysteine levels, increasing nitric oxide (NO) bioavailability, and promoting antioxidant and anti-inflammatory activities. Individuals living with SCD are more susceptible to vitamin B12 (B12) deficiency. However, there is a lack of clinical data investigating the relationship between systemic levels of B12, its supplementation, and reproductive outcome measures in SCD women. Therefore, this review aims to examine the current evidence regarding the impact of SCD on female reproductive health and the role of B12 in the reproductive biology of women living with SCD.

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Maternal and perinatal outcomes in pregnant women with sickle cell disease: an update

Cited by 12 publications

References 24 publications

Pregnancy in the Sickle Cell Disease and Fetomaternal Outcomes in Different Sickle cell Genotypes: A Systematic Review and Meta- Analysis

Pregnancy in the Sickle Cell Disease and Fetomaternal Outcomes in Different Sickle cell Genotypes: A Systematic Review and Meta- Analysis

Perinatal morbidity and mortality in neonates of mothers with sickle cell disease at the Teaching Hospital of Borgou /Alibori (Benin)-II

Impact of vitamin B12 on the reproductive health of women with sickle cell disease: a narrative review

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