Mathias Joacy G, Masese Rita V, King Allison A, Bulgin Dominique, Stevenson Eleanor, Hankins Jane S, Glassberg Jeffrey A, Kanter Julie, Preiss Liliana, Treadwell Marsha, Knisely Mitchell R, Tanabe Paula J, Gibson Robert, Gordeuk Victor R, Shah Nirmish R
Division of Women's Community and Population Health, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA.
Department of Bioethics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Int J Gynaecol Obstet. 2025 Mar;168(3):1131-1142. doi: 10.1002/ijgo.15974. Epub 2024 Oct 25.
Sickle cell disease (SCD) is associated with complications during pregnancy and can negatively influence maternal outcomes. Our study aimed to determine the prevalence and predictors of maternal morbidity among participants enrolled in an eight-site SCD Implementation Consortium (SCDIC) registry.
We conducted a cross-sectional analysis of female registry participants, aged 15-45 years, with a confirmed diagnosis of SCD. Participants completed a survey of self-reported pregnancies and outcomes.
Seven hundred and thirty-eight individuals had at least one pregnancy event, with 1076 live births. Twenty percent reported a pregnancy loss or fetal demise. Of the 1076 live births, 75% involved at least one complication. The most prevalent complications were pain crises (61.1%) and pregnancy requiring blood transfusion(s) (33.0%). Multiparous individuals with a prior occurrence of a complication in a previous pregnancy had higher odds of recurrence of the same complication in subsequent pregnancies (i.e., previous acute crisis was associated with subsequent acute pain events odds ratio [OR]: 3.13; 95% confidence interval [CI]: 2.06-4.76) and prior transfusion requiring another transfusion (OR: 3.22; 95% CI: 2.01-5.16).
Individuals reported a high prevalence of pregnancy loss and maternal complications. Our findings underscore the importance of preconception counseling and early initiation of perinatal care in SCD.
镰状细胞病（SCD）与孕期并发症相关，且会对孕产妇结局产生负面影响。我们的研究旨在确定参与八站点SCD实施联盟（SCDIC）登记处的参与者中孕产妇发病的患病率及预测因素。
我们对年龄在15至45岁、确诊为SCD的女性登记参与者进行了横断面分析。参与者完成了一项关于自我报告的妊娠情况及结局的调查。
738人至少有一次妊娠事件，共1076例活产。20%的人报告有妊娠丢失或胎儿死亡情况。在1076例活产中，75%至少涉及一种并发症。最常见的并发症是疼痛危象（61.1%）和需要输血的妊娠（33.0%）。既往妊娠有并发症的经产妇在随后妊娠中出现相同并发症复发的几率更高（即既往急性危象与随后急性疼痛事件的比值比[OR]：3.13；95%置信区间[CI]：2.06 - 4.76），以及既往输血后再次需要输血的情况（OR：3.22；95% CI：2.01 - 5.16）。
参与者报告妊娠丢失和孕产妇并发症的患病率较高。我们的研究结果强调了SCD患者孕前咨询和围产期护理尽早开始的重要性。
