Hemoglobinopathies in pregnancy

Rappaport, Valerie J.; Velazquez, Maria; Williams, Kayon

doi:10.1016/j.ogc.2004.03.006

Cited by 56 publications

(37 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, we were unable to assess differences in maternal complications according to SCD genotype because this information cannot be reliably detected using ICD-9-CM codes. Variations in the risk of adverse pregnancy outcomes according to SCD genotype have been reported with lower frequencies of maternal and fetal complications among women with HbSC disease than women with homozygous HbSS [7,14]. The implication of this limitation is that the prevalence of complications for certain subgroups may be overestimated or underestimated.…”

Section: Discussionmentioning

confidence: 99%

“…Repeated vaso-occlusive crises can affect multiple organ systems, and individuals with SCD have increased risk of stroke, renal dysfunction, pulmonary hypertension, retinal disease, and avascular necrosis [3,5,6]. In women with SCD, the underlying anemia and multi-organ dysfunction can complicate pregnancy, by affecting the cardiovascular, renal, hematologic, and respiratory systems [4,7]. Improvements in medical care and treatment for individuals with SCD coupled with advancements in neonatal care have contributed to a decline in morbidity and mortality associated with pregnancy among those with SCD; however, the physiological changes in pregnancy still carry important clinical risk for some patients with SCD [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population

Boulet

Okoroh

Azonobi

et al. 2013

Matern Child Health J

View full text Add to dashboard Cite

Higher frequencies of pregnancy complications have been reported among women with sickle cell disease (SCD) compared with those without SCD; however, past studies are limited by small sample size, narrow geographic area, and use of hospital discharge data. We compared the prevalence of maternal complications among intrapartum and postpartum women with SCD to those without SCD in a large, geographically diverse sample. Data from the 2004-2010 Truven Health MarketScan ® Multi-State Medicaid databases were used to assess the prevalence of maternal complications among intrapartum and postpartum women 15-44 years of age with and without SCD whose race was reported as black. The comparison group of women without SCD was further divided into those with chronic conditions associated with multi-organ failure and those without chronic conditions. Multivariable log-binomial regression models were used to calculate adjusted prevalence ratios for outcomes for women with SCD compared with women in the two comparison groups. Of the 335,348 black women with a delivery during 2004-2010, 1,526 had a diagnosis of SCD (0.5 %). Compared with women without SCD who had chronic conditions, women with SCD had higher prevalence of deep vein thrombosis, pulmonary HHS Public Access Author manuscriptMatern Child Health J. Author manuscript; available in PMC 2015 April 13. Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript embolism, obstetric shock, pneumonia, sepsis, postpartum infection, and transfusions. SCD was also positively associated with acute renal failure, cerebrovascular disorder, respiratory distress syndrome, eclampsia, postpartum hemorrhage, preterm birth, and ventilation when compared with women without SCD and chronic conditions. Overall, women with SCD have increased prevalence of pregnancy complications, even when compared with a group of women with similar risk for multi-organ failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population

Boulet

Okoroh

Azonobi

et al. 2013

Matern Child Health J

View full text Add to dashboard Cite

show abstract

“…The effectiveness of neonatal screening programs, when integrated into comprehensive follow-up services and coupled with parental education and support, has been clearly demonstrated in the US. [3][4][5][6] Although many European countries advocate for prenatal screening as an effective means to prevent births with clinically significant hemoglobinopathies, [7][8][9] studies in the US have failed to show widespread acceptance of prenatal diagnosis among pregnant women found to be at risk by prenatal screening. 10,11 Some states have implemented a strategy combining prenatal and neonatal screening programs in an effort to optimize care through prenatal counseling, education and early diagnosis.…”

Section: Historical Perspectivementioning

confidence: 99%

Newborn screening for non-sickling hemoglobinopathies

Hoppe¹

2009

Hematology

View full text Add to dashboard Cite

The hemoglobinopathies encompass a heterogeneous group of disorders associated with mutations in both the alpha-globin and beta-globin genes. Non-sickling disorders are found primarily in individuals of Mediterranean, Asian and Southeast Asian ancestry. With rapid growth in the Asian and Hispanic segments of the US population, the geographic distribution of hemoglobinopathies is expected to become significantly different from what it is today. The epidemiologic changes in the prevalence of non-sickling hemoglobin disorders have important implications for future public health programs, including newborn screening. The purpose of newborn screening for hemoglobinopathies is to identify clinically significant disorders and provide early education and specialized care prior to the onset of clinical symptoms. Although newborn screening for sickle cell disease is mandated in all states, screening for non-sickling hemoglobinopathies is directed in only one state and limited to reporting of a presumptive diagnosis in most other states. Early delivery of comprehensive care, as well as new and potentially curative therapies, has significantly improved the prognosis for affected patients. This review will consider the increasing prevalence of once uncommon hemoglobinopathies in the US, highlighting the rationale for expanding newborn screening beyond sickle cell disorders.

show abstract

“…The American College of Obstetrics and Gynecology currently advocates screening high-risk couples for the potential of having offspring with thalassemia or sickle cell disease. 28 High-risk groups for Hb H disease include those of Southeast Asian or Mediterranean descent. Some states with a significant proportion of Southeast Asians (eg, California) have implemented universal newborn screening programs to detect Hb H disease.…”

mentioning

confidence: 99%

“…If the MCV is low and iron deficiency anemia has been excluded, follow-up testing should be performed, such as Hb electrophoresis or fractionation and molecular genetic studies. 28,30 It is strongly recommended that all individuals with Hb H disease near or at reproductive age have his or her partner screened for alpha-and beta-thalassemia carrier status. 11,28,30 If the partner has heterozygous alpha-thalassemia 2 (a single alpha-globin gene deletion or inactivation), the fetus has a 25% chance of having Hb H disease.…”

mentioning

confidence: 99%