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- Title
Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?
- Authors
Gibson, Shanea M.P.; Hunter, Tiffany A.; Charles, Phillip E.; Morgan, Melonie A.C.; Griffith-Anderson, Shari K.R.; Cruickshank, J. Kennedy; Gossell-Williams, Maxine D.; Johnson, Nadine A.
- Abstract
Sickle cell disease (SCD) occurs in 2.8 % of our Jamaican antenatal population with homozygous HbSS being most associated with adverse maternal and perinatal outcomes. A retrospective comparative analysis of HbSS, HbSC and HbSβThal pregnancy outcomes at the University Hospital of the West Indies (UHWI) between January 2012 and December 2022 was conducted. Of 120 patients (138 pregnancies), obesity occurred in 36 % (20/56) of the 'non-HbSS' group, i.e. HbSβThal (55 %, 5/9) and HbSC (32 %, 15/47) combined vs. 9.7 % of the HbSS (8/82). HbSS patients had more crises requiring transfusions, acute chest syndrome (ACS), maternal 'near-misses' (OR=10.7, 95 % 3.5–32.3; p<0.001), hospitalizations (OR 7.6, 95 % CI 3.4–16.9; p<0.001), low birth weight (LBW) neonates (OR 3.1, 1.1–8.9; p=0.037) and preterm birth (OR=2.6, 1.2–5.8; p=0.018) compared to HbSC and HbSβThal. Low dose aspirin was prescribed in 43 %. Logistic regression showed those NOT on aspirin (n=76) had more miscarriages (22 v. 2 %), were LESS likely to have a live birth (75 v. 95 % (0.2, 0.04–0.57, p=0.005)), but surprisingly had fewer painful crises (28 v. 46 % (0.5, 0.03–0.9, p=0.03)). HbSS women had a 10-fold excess of maternal near-misses. Additional research may further clarify the effects of aspirin on pregnancy outcomes as related to SCD genotypes.
- Subjects
JAMAICA; SICKLE cell anemia; ACADEMIC medical centers; ASPIRIN; LOGISTIC regression analysis; PREGNANCY outcomes; RETROSPECTIVE studies; ODDS ratio; COMPARATIVE studies; CONFIDENCE intervals; PREGNANCY complications; GENOTYPES; DISEASE risk factors
- Publication
Journal of Perinatal Medicine, 2024, Vol 52, Issue 5, p485
- ISSN
0300-5577
- Publication type
Article
- DOI
10.1515/jpm-2023-0378