Sickle cell disease in pregnancy: Twenty years of experience at Grady Memorial Hospital, Atlanta, Georgia

Abstract

OBJECTIVE: We compared pregnancy outcomes among women with sickle cell disease with outcomes for African American women without the disease. STUDY DESIGN: We selected 127 deliveries in women with sickle cell disease (hemoglobin SS or hemoglobin SC) that occurred between 1980 and 1999. A control group of 129 deliveries by African American women with normal hemoglobin (hemoglobin AA) was also selected. Evaluated pregnancy outcomes included low birth weight, prematurity, intrauterine growth restriction, antepartum hospital admission, preterm labor or pre-term premature rupture of membranes, postpartum infection, preeclampsia, pyelonephritis, intrauterine fetal death, perinatal mortality, and maternal mortality. RESULTS: Compared with deliveries among women with hemoglobin AA, deliveries among women with hemoglobin SS or hemoglobin SC were at increased risk for intrauterine growth restriction, antepartum hospital admission, and postpartum infection. In addition, deliveries among women with Hb SS were more likely to be complicated by low birth weight, prematurity, and preterm labor or preterm premature rupture of membranes when compared with deliveries among women with hemoglobin AA. There were no significant differences among the groups (hemoglobin SS, hemoglobin SC, and hemoglobin AA) in terms of perinatal deaths; there were no maternal deaths in the study population. CONCLUSION: Those caring for women with sickle cell disease should be aware that they are at increased risk for pregnancy complications, although overall pregnancy outcome is favorable.