Study Confirms Link between Sickle Cell Disease, Higher Mortality in  Pregnancy

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Pregnant woman – Image file: MedlinePlus

Researchers from Johns Hopkins University School of Medicine,  have found a link between having the genetic blood illness sickle cell disease (SCD) and a noticeably greater risk of maternal morbidity and mortality .

The findings, published recently in JAMA Network Open, highlight a need for increased disease-specific interventions for pregnant women  with Sickle Cell Disease (SCD), as well as health disparities long known to affect people with the disorder.

The maternal death rate was 26 times higher than the national norm, according to their investigation, which used a sizable national administrative database containing records for pregnant individuals with SCD. Since this population's last assessment, this number has not changed, they said.

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“People with sickle cell disease are already lacking profoundly needed research and clinical care. Pregnant people with sickle cell disease are at an even greater disadvantage,” says Lydia Pecker, M.D., assistant professor of medicine specialising in haematology at the Johns Hopkins University School of Medicine.

In the study, researchers used the National Inpatient Sample, a nationally representative sample of hospital admissions in the United States, to apply the Severe Maternal Morbidity (SMM) index from the U.S. Centers for Disease Control and Prevention. They examined data gathered from 2012 to 2018 that contained 5,401,899 deliveries.

3,901 births among pregnant women with SCD and 742,164 deliveries among black persons were included in this total. Pregnant black women with sickle cell illness made up 84 percent of those who delivered.

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Maternal mortality, which is defined as dying during pregnancy, giving birth, or shortly afterward, was greatest in SCD patients over the research period, at 13.3 per 10,000, compared to 1.2 per 10,000 in pregnant black persons without SCD and 0.5 per 10,000 in non-black, non-SCD patients.

“Pregnancy can bring out negative side effects of any pre-existing condition, and sickle cell disease is no exception,” says Ahizechukwu Eke, associate professor of gynaecology and obstetrics at the Johns Hopkins University School of Medicine. “Sickle cell patients require more interventions, including increased blood transfusions and more frequent ultrasounds to assess the condition of the fetus.”

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The researchers noted that despite improvements in the care of people with SCD and improvements in the care of high-risk pregnancies, maternal mortality and morbidity rates of people with SCD have not improved. These findings suggest that advancements in SCD and high-risk OB care are not reaching enough pregnant women with SCD, the researchers say.

 

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