Maternal mortality among women with sickle cell disease in Jamaica over two decades (1998–2017)

McCaw-Binns, Affette; Campbell, Leroy A.; Harris, Ardene; James, Lesley-Ann; Asnani, Monika

doi:10.1016/j.eclinm.2021.101238

Cited by 3 publications

(2 citation statements)

References 47 publications

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“…1 In the Jamaican pregnant population, 2.8% of women have SCD. 2 This group of disorders is highly associated with increased maternal morbidity/mortality, 3 with the most common cause of maternal death being acute chest syndrome (ACS). 2 …”

Section: Introductionmentioning

confidence: 99%

“…2 This group of disorders is highly associated with increased maternal morbidity/mortality, 3 with the most common cause of maternal death being acute chest syndrome (ACS). 2 COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was officially declared a pandemic in March 2020. Patients with chronic medical illnesses are prone to severe disease/mortality.…”

Section: Introductionmentioning

confidence: 99%

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Case Report: Obstetric and COVID-19-Related Morbidity and Mortality in Three Patients with Sickle Hemoglobinopathy

Gibson,

Hunter,

Johnson

2024

The American Journal of Tropical Medicine and Hygiene

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Approximately 3% of pregnant women have sickle cell disease (SCD). COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became a global pandemic in March 2020, resulting in more than 3,500 deaths in Jamaica by April 2023. Sickle cell disease is an immunocompromised state; therefore, contracting COVID-19 may result in adverse maternal/neonatal outcomes. Current literature focusing on individuals of Afro-Caribbean descent is limited. Our objective was to describe the obstetric and neonatal outcomes of pregnant patients with SCD who contracted COVID-19. A retrospective case series was conducted at the University Hospital of the West Indies (Jamaica) from 2020 to 2022. We describe the maternal and neonatal outcomes of three patients with COVID-19 and SCD (including two with hemoglobin SC disease and one with hemoglobin SS disease), with complications including the demise of a mother and a newborn. Vaso-occlusive crisis was the more common presentation. Two patients required ventilatory support. Although previous reports have shown similar clinical sequelae in pregnant and nonpregnant patients with SCD and COVID-19, maternal and neonatal deaths remain possible.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Case Report: Obstetric and COVID-19-Related Morbidity and Mortality in Three Patients with Sickle Hemoglobinopathy

Gibson,

Hunter,

Johnson

2024

The American Journal of Tropical Medicine and Hygiene

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Adverse pregnancy, fetal and neonatal outcomes in women with sickle cell disease in a Middle Eastern country

Saif Said AL Harthi,

Arulappan,

Al Yazeedi

et al. 2024

Womens Health (Lond Engl)

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Background: Sickle cell disease in pregnancy is associated with high maternal and fetal mortality. However, studies reporting pregnancy, fetal, and neonatal outcomes in women with sickle cell disease are extremely limited. Objectives: The objectives of the study are to determine whether women with sickle cell disease have a greater risk of adverse pregnancy, fetal, and neonatal outcomes than women without sickle cell disease and identify the predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. Design: A retrospective pair-matched case-control study was conducted to compare 171 pregnant women with sickle cell disease to 171 pregnant women without sickle cell disease in Muscat, Sultanate of Oman. Methods: All pregnant Omani women with sickle cell disease who delivered between January 2015 and August 2021 at Sultan Qaboos University Hospital and Royal Hospital, who were either primipara or multipara and who had a gestational age of 24–42 weeks, were included as patients, whereas women who had no sickle cell disease or any comorbidity during pregnancy, who delivered within the same timeframe and at the same hospitals, were recruited as controls. The data were retrieved from electronic medical records and delivery registry books between January 2015 and August 2021. Results: Women with sickle cell disease who had severe anemia had increased odds of (χ2 = 58.56, p < 0.001) having adverse pregnancy outcomes. Women with sickle cell disease had 21.97% higher odds of delivering a baby with intrauterine growth retardation (χ2 = 17.80, unadjusted odds ratio = 2.91–166.13, p < 0.001). Newborns born to women with sickle cell disease had 3.93% greater odds of being admitted to the neonatal intensive care unit (χ2 = 16.80, unadjusted odds ratio = 1.97–7.84, p < 0.001). In addition, the children born to women with sickle cell disease had 10.90% higher odds of being born with low birth weight (χ2 = 56.92, unadjusted odds ratio = 5.36–22.16, p < 0.001). Hemoglobin level (odds ratio = 0.17, p < 0.001, 95% confidence interval = 0.10–3.0), past medical history (odds ratio = 7.95, p < 0.001, 95% confidence interval = 2.39–26.43), past surgical history (odds ratio = 17.69, p < 0.001, 95% confidence interval = 3.41–91.76), and preterm delivery (odds ratio = 9.48, p = 0.005, 95% confidence interval = 1.95–46.23) were identified as predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. Conclusion: As pregnant women with sickle cell disease are at increased risk for pregnancy, fetal, and neonatal adverse outcomes; improved antenatal surveillance and management may improve the outcomes.

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Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?

Gibson,

Hunter,

Charles

et al. 2024

Journal of Perinatal Medicine

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Objectives Sickle cell disease (SCD) occurs in 2.8 % of our Jamaican antenatal population with homozygous HbSS being most associated with adverse maternal and perinatal outcomes. Methods A retrospective comparative analysis of HbSS, HbSC and HbSβThal pregnancy outcomes at the University Hospital of the West Indies (UHWI) between January 2012 and December 2022 was conducted. Results Of 120 patients (138 pregnancies), obesity occurred in 36 % (20/56) of the ‘non-HbSS’ group, i.e. HbSβThal (55 %, 5/9) and HbSC (32 %, 15/47) combined vs. 9.7 % of the HbSS (8/82). HbSS patients had more crises requiring transfusions, acute chest syndrome (ACS), maternal ‘near-misses’ (OR=10.7, 95 % 3.5–32.3; p<0.001), hospitalizations (OR 7.6, 95 % CI 3.4–16.9; p<0.001), low birth weight (LBW) neonates (OR 3.1, 1.1–8.9; p=0.037) and preterm birth (OR=2.6, 1.2–5.8; p=0.018) compared to HbSC and HbSβThal. Low dose aspirin was prescribed in 43 %. Logistic regression showed those NOT on aspirin (n=76) had more miscarriages (22 v. 2 %), were LESS likely to have a live birth (75 v. 95 % (0.2, 0.04–0.57, p=0.005)), but surprisingly had fewer painful crises (28 v. 46 % (0.5, 0.03–0.9, p=0.03)). Conclusions HbSS women had a 10-fold excess of maternal near-misses. Additional research may further clarify the effects of aspirin on pregnancy outcomes as related to SCD genotypes.

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Maternal mortality among women with sickle cell disease in Jamaica over two decades (1998–2017)

Cited by 3 publications

References 47 publications

Case Report: Obstetric and COVID-19-Related Morbidity and Mortality in Three Patients with Sickle Hemoglobinopathy

Case Report: Obstetric and COVID-19-Related Morbidity and Mortality in Three Patients with Sickle Hemoglobinopathy

Adverse pregnancy, fetal and neonatal outcomes in women with sickle cell disease in a Middle Eastern country

Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?

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