Wellenstein Whitney L, Sullivan Shannon, Darbinian Jeanne, Ritterman Weintraub Miranda L, Greenberg Mara
Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Oakland, California.
Division of Research, Kaiser Permanente Medical Center, Oakland, California.
AJP Rep. 2019 Oct;9(4):e346-e352. doi: 10.1055/s-0039-1695743. Epub 2019 Nov 11.
To compare adverse pregnancy outcomes between women with sickle cell trait (SCT) and women with normal hemoglobin. A retrospective cohort study of women who delivered within Kaiser Permanente Northern California between 2006 and 2013. Using hemoglobin electrophoretic profiles, we defined women with hemoglobin AS (HbAS) as having SCT and those with hemoglobin AA (HbAA) as having normal hemoglobin. Outcomes were pregnancy-induced hypertension (PIH), small for gestational age (SGA), gestational diabetes (GDM), and preterm delivery (PTD). Demographic and pregnancy outcome variations were assessed in bivariate analyses. Multivariable logistic regression modeling was used to estimate odds ratios for the association between primary outcomes and selected characteristics. Of 31,840 eligible women, 868 (2.7%) had SCT. Women with SCT were more likely to have PIH (15.6% vs. 12.2%, p value = 0.003) and SGA (8.3% vs. 6.1%, p value = 0.008), less likely to have GDM (6.8% vs. 9.8%, p value = 0.003) and had similar PTD prevalence (8.1% vs. 7.6%, p value = 0.600). In multivariable analyses, SCT was not an independent predictor of these outcomes. Racial/ethnic minorities had higher adjusted odds of PIH, SGA, and GDM. SCT alone does not appear to be associated with adverse pregnancy outcomes. Race/ethnicity is a risk factor for adverse pregnancy outcomes.
比较镰状细胞性状（SCT）女性与血红蛋白正常女性的不良妊娠结局。
对2006年至2013年在北加利福尼亚凯撒医疗中心分娩的女性进行回顾性队列研究。利用血红蛋白电泳图谱，我们将血红蛋白AS（HbAS）的女性定义为患有SCT，将血红蛋白AA（HbAA）的女性定义为血红蛋白正常。结局指标为妊娠高血压（PIH）、小于胎龄儿（SGA）、妊娠期糖尿病（GDM）和早产（PTD）。在双变量分析中评估人口统计学和妊娠结局差异。采用多变量逻辑回归模型估计主要结局与选定特征之间关联的比值比。
在31840名符合条件的女性中，868名（2.7%）患有SCT。患有SCT的女性更易发生PIH（15.6%对12.2%，p值 = 0.003）和SGA（8.3%对6.1%，p值 = 0.008），发生GDM的可能性较小（6.8%对9.8%，p值 = 0.003），且PTD患病率相似（8.1%对7.6%，p值 = 0.600）。在多变量分析中，SCT不是这些结局的独立预测因素。种族/族裔少数群体发生PIH、SGA和GDM的校正比值较高。
单独的SCT似乎与不良妊娠结局无关。种族/族裔是不良妊娠结局的一个危险因素。
