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Perinatal and maternal outcomes in women with sickle or hemoglobin C trait.
Obstet Gynecol. 2007 Nov; 110(5):1113-9.OG

Abstract

OBJECTIVE

Recent studies have reported increased fetal loss and preeclampsia in women with sickle cell trait (hemoglobin [Hb] AS). There is a paucity of studies of outcomes in carriers of hemoglobin C. We examined the prevalence of hemoglobin C and S carrier status (Hb AC and Hb AS, respectively) and their effect on pregnancy outcomes.

METHODS

This was a retrospective cohort study using data prospectively collected from 1991 to 2006. Perinatal and maternal outcomes for African-American women with Hb AS and Hb AC were compared with those with normal hemoglobin (Hb AA). Multivariable regression was performed by applying generalized estimating equations to account for correlation between births from the same woman.

RESULTS

Among 22,096 eligible African-American women (36,897 pregnancies) with routine antenatal hemoglobin electrophoresis, 88.5% had a normal (Hb AA) pattern. Hemoglobin AS was identified in 8.2% and Hb AC in 2.4% of women. Hemoglobin SS and Hb SC each accounted for less than 0.2% and Hb CC for 0.01%. Prevalence and relative risks for adverse outcomes in 3,019 AS pregnancies (3,062 births) and 875 AC (886 births), compared with 32,724 AA pregnancies (33,213 births), were not increased. Adjusted relative risks (95% confidence intervals) for perinatal mortality and preeclampsia were 0.7 (0.5-1.0) and 1.0 (0.8-1.2), respectively, for AS and 0.7 (0.3-1.4) and 1.0 (0.6-1.3), respectively, for AC. Risks of stillbirths and pregnancy-associated hypertension were also not increased.

CONCLUSION

Contrary to other recent reports, perinatal mortality and preeclampsia are not increased in carriers of sickle cell trait or hemoglobin C.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

Center for Women's Reproductive Health and Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. alan.tita@obgyn.uab.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17978127

Citation

Tita, Alan T N., et al. "Perinatal and Maternal Outcomes in Women With Sickle or Hemoglobin C Trait." Obstetrics and Gynecology, vol. 110, no. 5, 2007, pp. 1113-9.
Tita AT, Biggio JR, Chapman V, et al. Perinatal and maternal outcomes in women with sickle or hemoglobin C trait. Obstet Gynecol. 2007;110(5):1113-9.
Tita, A. T., Biggio, J. R., Chapman, V., Neely, C., & Rouse, D. J. (2007). Perinatal and maternal outcomes in women with sickle or hemoglobin C trait. Obstetrics and Gynecology, 110(5), 1113-9.
Tita AT, et al. Perinatal and Maternal Outcomes in Women With Sickle or Hemoglobin C Trait. Obstet Gynecol. 2007;110(5):1113-9. PubMed PMID: 17978127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perinatal and maternal outcomes in women with sickle or hemoglobin C trait. AU - Tita,Alan T N, AU - Biggio,Joseph R, AU - Chapman,Victoria, AU - Neely,Cherry, AU - Rouse,Dwight J, PY - 2007/11/6/pubmed PY - 2007/12/7/medline PY - 2007/11/6/entrez SP - 1113 EP - 9 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 110 IS - 5 N2 - OBJECTIVE: Recent studies have reported increased fetal loss and preeclampsia in women with sickle cell trait (hemoglobin [Hb] AS). There is a paucity of studies of outcomes in carriers of hemoglobin C. We examined the prevalence of hemoglobin C and S carrier status (Hb AC and Hb AS, respectively) and their effect on pregnancy outcomes. METHODS: This was a retrospective cohort study using data prospectively collected from 1991 to 2006. Perinatal and maternal outcomes for African-American women with Hb AS and Hb AC were compared with those with normal hemoglobin (Hb AA). Multivariable regression was performed by applying generalized estimating equations to account for correlation between births from the same woman. RESULTS: Among 22,096 eligible African-American women (36,897 pregnancies) with routine antenatal hemoglobin electrophoresis, 88.5% had a normal (Hb AA) pattern. Hemoglobin AS was identified in 8.2% and Hb AC in 2.4% of women. Hemoglobin SS and Hb SC each accounted for less than 0.2% and Hb CC for 0.01%. Prevalence and relative risks for adverse outcomes in 3,019 AS pregnancies (3,062 births) and 875 AC (886 births), compared with 32,724 AA pregnancies (33,213 births), were not increased. Adjusted relative risks (95% confidence intervals) for perinatal mortality and preeclampsia were 0.7 (0.5-1.0) and 1.0 (0.8-1.2), respectively, for AS and 0.7 (0.3-1.4) and 1.0 (0.6-1.3), respectively, for AC. Risks of stillbirths and pregnancy-associated hypertension were also not increased. CONCLUSION: Contrary to other recent reports, perinatal mortality and preeclampsia are not increased in carriers of sickle cell trait or hemoglobin C. LEVEL OF EVIDENCE: II. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/17978127/Perinatal_and_maternal_outcomes_in_women_with_sickle_or_hemoglobin_C_trait_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=17978127.ui DB - PRIME DP - Unbound Medicine ER -