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Sickle cell disease and pregnancy outcomes: women of African descent.
Am J Prev Med. 2010 Apr; 38(4 Suppl):S542-9.AJ

Abstract

BACKGROUND

Sickle cell disease (SCD) is a severe hematologic condition that presents unique complications among affected pregnant women. Many studies of adverse perinatal outcomes associated with SCD are limited by small samples or fail to consider important risk factors.

PURPOSE

This study compared perinatal outcomes among women of African ancestry with and without SCD in a large, population-based sample.

METHODS

Data from the Massachusetts Pregnancy to Early Life Longitudinal (PELL) Data System were analyzed during June-August 2009 to identify in-state deliveries to resident women of African descent. Logistic regression analyses compared perinatal outcomes for deliveries among women with and without SCD, adjusted for maternal age, education, parity, plurality, insurance status, adequacy of prenatal care, smoking during pregnancy, and infant gender.

RESULTS

During 1998-2006, there were 116,076 deliveries to 84,561 women; SCD prevalence was 0.6%. Adjusted odds of fetal death among deliveries to women with SCD were 2.2 times those among women without SCD (95% CI=1.2, 4.2). Compared to women without SCD, the odds of preterm delivery, low birth weight, and having babies small for gestational age (SGA) among women with SCD were 1.5 (95% CI=1.2, 1.8); 1.7 (95% CI=1.1, 2.6); and 1.3 (95% CI=1.0, 1.7), respectively. Sickle cell disease was positively associated with cesarean delivery and inductions.

CONCLUSIONS

Population-based linked data systems are useful for assessing risks of adverse health outcomes among women with specific medical conditions, such as SCD. Women with SCD should seek preconception care to identify and modify risk behaviors and receive counseling regarding potential adverse sequelae associated with pregnancy-related morbidity and preterm delivery.

Authors+Show Affiliations

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia 30341, USA. wbarfield@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

20331956

Citation

Barfield, Wanda D., et al. "Sickle Cell Disease and Pregnancy Outcomes: Women of African Descent." American Journal of Preventive Medicine, vol. 38, no. 4 Suppl, 2010, pp. S542-9.
Barfield WD, Barradas DT, Manning SE, et al. Sickle cell disease and pregnancy outcomes: women of African descent. Am J Prev Med. 2010;38(4 Suppl):S542-9.
Barfield, W. D., Barradas, D. T., Manning, S. E., Kotelchuck, M., & Shapiro-Mendoza, C. K. (2010). Sickle cell disease and pregnancy outcomes: women of African descent. American Journal of Preventive Medicine, 38(4 Suppl), S542-9. https://doi.org/10.1016/j.amepre.2009.12.020
Barfield WD, et al. Sickle Cell Disease and Pregnancy Outcomes: Women of African Descent. Am J Prev Med. 2010;38(4 Suppl):S542-9. PubMed PMID: 20331956.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sickle cell disease and pregnancy outcomes: women of African descent. AU - Barfield,Wanda D, AU - Barradas,Danielle T, AU - Manning,Susan E, AU - Kotelchuck,Milton, AU - Shapiro-Mendoza,Carrie K, PY - 2009/09/16/received PY - 2009/12/16/revised PY - 2009/12/22/accepted PY - 2010/3/25/entrez PY - 2010/4/2/pubmed PY - 2010/4/27/medline SP - S542 EP - 9 JF - American journal of preventive medicine JO - Am J Prev Med VL - 38 IS - 4 Suppl N2 - BACKGROUND: Sickle cell disease (SCD) is a severe hematologic condition that presents unique complications among affected pregnant women. Many studies of adverse perinatal outcomes associated with SCD are limited by small samples or fail to consider important risk factors. PURPOSE: This study compared perinatal outcomes among women of African ancestry with and without SCD in a large, population-based sample. METHODS: Data from the Massachusetts Pregnancy to Early Life Longitudinal (PELL) Data System were analyzed during June-August 2009 to identify in-state deliveries to resident women of African descent. Logistic regression analyses compared perinatal outcomes for deliveries among women with and without SCD, adjusted for maternal age, education, parity, plurality, insurance status, adequacy of prenatal care, smoking during pregnancy, and infant gender. RESULTS: During 1998-2006, there were 116,076 deliveries to 84,561 women; SCD prevalence was 0.6%. Adjusted odds of fetal death among deliveries to women with SCD were 2.2 times those among women without SCD (95% CI=1.2, 4.2). Compared to women without SCD, the odds of preterm delivery, low birth weight, and having babies small for gestational age (SGA) among women with SCD were 1.5 (95% CI=1.2, 1.8); 1.7 (95% CI=1.1, 2.6); and 1.3 (95% CI=1.0, 1.7), respectively. Sickle cell disease was positively associated with cesarean delivery and inductions. CONCLUSIONS: Population-based linked data systems are useful for assessing risks of adverse health outcomes among women with specific medical conditions, such as SCD. Women with SCD should seek preconception care to identify and modify risk behaviors and receive counseling regarding potential adverse sequelae associated with pregnancy-related morbidity and preterm delivery. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/20331956/Sickle_cell_disease_and_pregnancy_outcomes:_women_of_African_descent_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(09)00958-1 DB - PRIME DP - Unbound Medicine ER -