Pregnancy in sickle cell disease is at very high risk. Many reports have documented a considerable maternal risk of morbidity and mortality and high perinatal adverse outcomes . Previously, several systematic review and meta-analysis of previous observational studies, have quantified this risk. They showed that women with SCD have an increased risk of preeclampsia and maternal death, stillbirths, preterm deliveries, and small-for-gestational-age newborns.
In a new development, lower risk of intrauterine fetal death for those women with sickle cell disease (SCD) who received more transfusions throughout pregnancy, has been noted in a recent study result, published in Hematology, Transfusion, and Cell Therapy.
The aim of this study was to describe maternal and perinatal outcomes in pregnant women with sickle cell disease (SCD) followed at Santa Casa de Sao Paulo over a 10-year period (between 2010 and 2019).
As for the study design,Fifty-five records of pregnancies were analyzed among 35 women with SCD.
Data analysis revealed the following facts.
Among 29 newborns, 19 (65.5%) were full-term and 10 pre-term; 24 (82.7%) caesareans and 5 (17.2%) natural births were observed.
The mean gestational age at birth and mother`s age were 36.6 weeks (30–40) and 26.7 years (17–39), respectively. No maternal death was observed.
The main maternal obstetric and non-obstetric complications were: pre-eclampsia and gestational diabetes, and vaso-occlusive crisis, urinary tract infection and acute chest syndrome, respectively.
Twenty-six (47.0%) fetal deaths were observed, 24 being intrauterine fetal (14 early abortions, 10 late abortions and 2 stillbirths). Regarding the red blood cell transfusion history, 40 (72.7%) out of 55 pregnancies received transfusion.
Pregnant women who received 6 or more transfusions throughout pregnancy had a significantly lower number of abortions, i.e., no cases of early abortion and only 1 case of late abortion, versus 14 and 9 cases in pregnancies with 0–5 transfusions, respectively.
Despite advances in the management of SCD, pregnant women with SCD (particularly those with HbSS) are at a high risk for maternal and fetal complications, even though they are followed in reference centers.For the full article follow the link: https://doi.org/10.1016/j.htct.2020.12.009
Primary source: Hematology, Transfusion, and Cell Therapy.