Sickle cell disease and pregnancy in Bahrain

Rajab, Khalil E.; Issa, Abdulla A.; Mohammed, AD; Ajami, Abolghasem

doi:10.1016/j.ijgo.2006.02.007

Cited by 44 publications

(41 citation statements)

References 15 publications

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“…Rajab[25] suggests a MMR of 1140/100,000 (4 of 351 births) in their women with SCD (similar to 1120/100 000 in our second five year period). Without correcting for pregnancy outcomes (stillbirths and live births), this ratio is also similar to Serjeant's experience in Jamaica[4] (1220/100 000), which would be higher if the denominator was restricted to live births (1724/100 000).…”

Section: Discussionsupporting

confidence: 77%

Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007

2011

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BackgroundDecreases in direct maternal deaths in Jamaica have been negated by growing indirect deaths. With sickle cell disease (SCD) a consistent underlying cause, we describe the epidemiology of maternal deaths in this population.MethodsDemographic, service delivery and cause specific mortality rates were compared among women with (n = 42) and without SCD (n = 376), and between SCD women who died in 1998–2002 and 2003–7.ResultsWomen with SCD had fewer viable pregnancies (p: 0.02) despite greater access to high risk antenatal care (p: 0.001), and more often died in an intensive care unit (p: 0.002). In the most recent period (2003–7) SCD women achieved more pregnancies (median 2 vs. 3; p: 0.009), made more antenatal visits (mean 3.3 vs. 7.3; p: 0.01) and were more often admitted antenatally (p:<0.0001). The maternal mortality ratio for SCD decedents was 7–11 times higher than the general population, with 41% of deaths attributable to their disorder. Cause specific mortality was higher for cardiovascular complications, gestational hypertension and haemorrhage. Respiratory failure was the leading immediate cause of death.ConclusionsWomen with SCD experience a significant excess risk of dying in pregnancy and childbirth [MMR: (SCD) 719/100,000, (non SCD) 78/100,000]. MDG5 cannot be realised without improving care for women with SCD. Tertiary services (e.g. ventilator support) are needed at regional centres to improve outcomes in this and other high risk populations. Universal SCD screening in pregnancy in populations of African and Mediterranean descent is needed as are guidelines for managing SCD pregnancies and educating families with SCD.

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Section: Discussionsupporting

confidence: 77%

Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007

2011

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“…[24][25][26][27][28][29][30][31] All studies were categorized as pregnancy cohort studies. Thirteen studies originated For personal use only.…”

Section: Study Characteristicsmentioning

confidence: 99%

Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis

Oteng‐Ntim

Meeks

Seed

et al. 2015

Blood

187

223

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Key Points• Pregnant women with sickle cell disease have high risks of adverse maternal and perinatal outcomes.• The risks are greatest for those with HbSS disease (vs HbSC disease) and those in low income (vs high income) countries.A systematic review and meta-analysis of observational studies were conducted to quantify the association between sickle cell disease in pregnancy and adverse maternal and perinatal outcomes. 32-5.98). Meta-regression demonstrated that genotype (HbSS vs HbSC), low gross national income, and high study quality were associated with increased RRs. Despite advances in the management of sickle cell disease, obstetrics, and neonatal medicine, pregnancies complicated by the disease remain associated with increased risk of adverse maternal and perinatal outcomes. (Blood. 2015;125(21):3316-3325)

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“…Entretanto, a taxa de morbidade materna permanece elevada, com elevada prevalência de complicações, como: pielonefrite, pneumonia, septicemia, pré-eclâmpsia e eclâmpsia, eventos tromboembólicos, síndrome torácica aguda, sangramento anteparto, descolamento prematuro da placenta, prematuridade, endometrite e infecções pós-parto, cesárea, necessidade de transfusões sanguíneas, hipertensão pulmonar, entre outras [3][4][5][6][7] . A morbidade fetal também é significativa, incluindo: aborto, restrição de crescimento, óbito fetal, prematuridade e recém-nascido de baixo peso [8][9][10] . No Brasil, a anemia falciforme é uma doença hematológica hereditária de alta prevalência.…”

Section: Introductionunclassified

Resultados maternos e perinatais em gestações complicadas por doenças falciformes

Nomura¹,

Igai²,

Tosta³

et al. 2010

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: avaliar os resultados maternos e perinatais de gestações complicadas por doenças falciformes, comparandoas com portadoras de traço falciforme. MÉTODOS: este estudo é uma coorte retrospectiva, abrangendo o período de Março de 2001 a Abril de 2008, tendo sido incluídas todas as gestantes portadoras de doença falciforme (n=42) acompanhadas em hospital universitário da região sudeste do Brasil. Os resultados maternos e perinatais foram comparados com os de gestantes portadoras de traço falciforme (n=56) acompanhadas no mesmo serviço. RESULTADOS: a hemoglobinopatia SS foi diagnosticada em 42 gestantes (82,4%) e a SC em nove (17,6%). A idade materna foi significativamente menor no grupo com doença falciforme (média=26,0; SD=4,3) quando comparadas às com traço falciforme (média=28,7, DP=7,1; p=0,018). As seguintes complicações maternas foram significativamente mais frequentes no grupo com doença falciforme em comparação ao grupo com traço falciforme: infecção do trato urinário (25,5 versus 8,9%; p=0,04), pneumonia (23,5 versus 1,8%; p=0,002), hipertensão pulmonar (15,7 versus 0%; p=0,002), e transfusão no parto/pós-parto (33,3 versus 5,4%; p=0,001). Resultados perinatais adversos foram significativamente mais frequentes no grupo com doença falciforme quando comparados ao grupo com traço falciforme: prematuridade (49 versus 25%; p=0,01), média da idade gestacional no parto (35,2 versus 37,9 semanas; p<0,001), diagnóstico de sofrimento fetal (56,9 versus 28,6%; p=0,006), peso do recém-nascido <2.500g (62,7 versus 17,9%; p<0,001), média do peso do recém-nascido (2.183 versus 2.923 g; p<0,001) e recém-nascidos pequenos para a idade gestacional (29,4 versus 10,7%; p=0,02). Duas mortes maternas (3,9%) ocorreram no grupo com doença falciforme. CONCLUSÕES: gestantes portadoras de doença falciforme apresentam maior risco para morbidade materna e resultados perinatais adversos quando comparadas às portadoras de traço falciforme.Abstract PURPOSE: the aim of this study was to describe perinatal and maternal outcomes of pregnancies complicated by sickle cell disease (SCD), comparing to pregnancies of women with sickle cell trait (SCT). METHODS: this was a retrospective cohort study, covering the period from March 2001 to April 2008, which included all pregnant women with SCD (n=42) followed up at a university hospital in the Southeast region of Brazil. The maternal and perinatal outcomes were compared to those of pregnant women with SCT (n=56) who were followed up at the same service. RESULTS: SCD-SS was diagnosed in 42 (82.4%) pregnant women and SC in 9 (17.6%). Mean (±SD) maternal age was significantly lower in the SCD group (26.0 years) compared to SCT women (28.7±7.1 years; p=0.018). The following maternal complications were more common among women with SCD in comparison to SCT: urinary tract infection (25.5 versus 8.9%; p=0.04), pneumonia (23.5 versus 1.8%; p=0.002), pulmonary hypertension (15.7 versus 0%; p=0.002), and blood transfusion during delivery or postpartum (33.3 versus 5.4%; p=0.001). Adverse perinat...

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Sickle cell disease and pregnancy in Bahrain

Abstract: Mortality, morbidity, and perinatal loss are still considerable among women with SCD in Bahrain. To reduce mortality and morbidity, there is a need for a multidisciplinary team able to deal with pregnancy complications due to SCD.

Cited by 44 publications

References 15 publications

Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007

Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007

Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis

Resultados maternos e perinatais em gestações complicadas por doenças falciformes

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