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  • Title: Adverse clinical and obstetric outcomes among pregnant women with different sickle cell disease genotypes.
    Author: Silva FAC, Ferreira ALCG, Hazin-Costa MF, Dias MLG, Araújo AS, Souza AI.
    Journal: Int J Gynaecol Obstet; 2018 Oct; 143(1):89-93. PubMed ID: 30030929.
    Abstract:
    OBJECTIVE: To compare clinical and obstetric adverse events among pregnant women with sickle cell disease (SCD) according to genotype. METHODS: The present cross-sectional study enrolled women aged 15-49 years with SCD and prior pregnancy attending a hematology center in Recife, Brazil, between September 1, 2015, and April 30, 2016. Associations between sickle cell genotype (HbSS, HbSC, Sβ-thalassemia) and adverse events were evaluated. RESULTS: Overall, 89 women were included; 74 (83%) had HbSS genotype, 8 (9%) had HbSC genotype, and 7 (8%) had Sβ-thalassemia genotype. Fifty-three (60%) self-reported being of mixed race, and 27 (30%) self-reported they were black. Blood transfusion was observed more frequently among women with HbSS than among those with HbSC genotype (P=0.007). Postpartum adverse events were more frequent in the Sβ-thalassemia than in the HbSS group (P=0.030). Fetal intrauterine death occurred only among women with the HbSS genotype (11 [15%]). In the HbSS group, there was a higher frequency of blood transfusion (P=0.004) and lower rate of spontaneous abortion (P=0.001) among women with six or more consultations. CONCLUSION: The HbSS genotype was associated with a higher frequency of blood transfusion. Sβ-thalassemia was associated with a higher frequency of postpartum adverse events. Prenatal care was associated with a lower rate of spontaneous abortion in the HbSS group.
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