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- Title
Adverse pregnancy, fetal and neonatal outcomes in women with sickle cell disease in a Middle Eastern country.
- Authors
Saif Said AL Harthi, Salwa; Arulappan, Judie; Al Yazeedi, Basma; Al Zaabi, Asma Hassan Salmeen
- Abstract
Background: Sickle cell disease in pregnancy is associated with high maternal and fetal mortality. However, studies reporting pregnancy, fetal, and neonatal outcomes in women with sickle cell disease are extremely limited. Objectives: The objectives of the study are to determine whether women with sickle cell disease have a greater risk of adverse pregnancy, fetal, and neonatal outcomes than women without sickle cell disease and identify the predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. Design: A retrospective pair-matched case-control study was conducted to compare 171 pregnant women with sickle cell disease to 171 pregnant women without sickle cell disease in Muscat, Sultanate of Oman. Methods: All pregnant Omani women with sickle cell disease who delivered between January 2015 and August 2021 at Sultan Qaboos University Hospital and Royal Hospital, who were either primipara or multipara and who had a gestational age of 24–42 weeks, were included as patients, whereas women who had no sickle cell disease or any comorbidity during pregnancy, who delivered within the same timeframe and at the same hospitals, were recruited as controls. The data were retrieved from electronic medical records and delivery registry books between January 2015 and August 2021. Results: Women with sickle cell disease who had severe anemia had increased odds of (χ2 = 58.56, p < 0.001) having adverse pregnancy outcomes. Women with sickle cell disease had 21.97% higher odds of delivering a baby with intrauterine growth retardation (χ2 = 17.80, unadjusted odds ratio = 2.91–166.13, p < 0.001). Newborns born to women with sickle cell disease had 3.93% greater odds of being admitted to the neonatal intensive care unit (χ2 = 16.80, unadjusted odds ratio = 1.97–7.84, p < 0.001). In addition, the children born to women with sickle cell disease had 10.90% higher odds of being born with low birth weight (χ2 = 56.92, unadjusted odds ratio = 5.36–22.16, p < 0.001). Hemoglobin level (odds ratio = 0.17, p < 0.001, 95% confidence interval = 0.10–3.0), past medical history (odds ratio = 7.95, p < 0.001, 95% confidence interval = 2.39–26.43), past surgical history (odds ratio = 17.69, p < 0.001, 95% confidence interval = 3.41–91.76), and preterm delivery (odds ratio = 9.48, p = 0.005, 95% confidence interval = 1.95–46.23) were identified as predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. Conclusion: As pregnant women with sickle cell disease are at increased risk for pregnancy, fetal, and neonatal adverse outcomes; improved antenatal surveillance and management may improve the outcomes.
- Subjects
OMAN; FETAL growth retardation -- Risk factors; RISK factors of preeclampsia; RISK factors in premature labor; RESEARCH; STATISTICS; CONFIDENCE intervals; HEMOGLOBINS; POSTPARTUM hemorrhage; NEONATAL intensive care; AGE distribution; BLOOD transfusion; MULTIPLE regression analysis; RETROSPECTIVE studies; CASE-control method; PREGNANT women; ACQUISITION of data; TERTIARY care; GESTATIONAL age; GOODNESS-of-fit tests; NEONATAL intensive care units; PATIENTS; PREGNANCY outcomes; RISK assessment; T-test (Statistics); COMPARATIVE studies; SEVERITY of illness index; LOW birth weight; HOSPITAL admission &; discharge; PREGNANCY complications; MEDICAL records; CHI-squared test; DESCRIPTIVE statistics; MATERNAL age; RESEARCH funding; ODDS ratio; INFANT mortality; STATISTICAL sampling; DATA analysis software; BODY mass index; LOGISTIC regression analysis; PRENATAL care; CESAREAN section; STATISTICAL models; FETAL distress; APGAR score; SICKLE cell anemia; WOMEN'S health; ECLAMPSIA; DISEASE risk factors
- Publication
Women's Health (17455057), 2024, p1
- ISSN
1745-5057
- Publication type
Article
- DOI
10.1177/17455057231220188