Sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypes
Background: Sickle cell disease (SCD) comprises a heterogeneous group of inherited hemolytic disorders that increases the risk of maternal and perinatal complications due to chronic systemic inflammatory response, endothelial damage and vaso-occlusion. The contribution of genotypes to the severity o...
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Elsevier
2024-11-01
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| Series: | Hematology, Transfusion and Cell Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137924000567 |
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| author | Camilla Olivares Figueira José Paulo S. Guida Fernanda G. Surita Arthur Antolini-Tavares Sara T. Saad Fernando F. Costa Kleber Y. Fertrin Maria Laura Costa |
| author_facet | Camilla Olivares Figueira José Paulo S. Guida Fernanda G. Surita Arthur Antolini-Tavares Sara T. Saad Fernando F. Costa Kleber Y. Fertrin Maria Laura Costa |
| author_sort | Camilla Olivares Figueira |
| collection | DOAJ |
| description | Background: Sickle cell disease (SCD) comprises a heterogeneous group of inherited hemolytic disorders that increases the risk of maternal and perinatal complications due to chronic systemic inflammatory response, endothelial damage and vaso-occlusion. The contribution of genotypes to the severity of outcomes during pregnancy is not completely established. Methods: A retrospective study of medical charts was performed to compare maternal and perinatal outcomes in Hb SS, Hb SC disease and sickle-beta thalassemia (Hb Sβ) pregnancies followed at a high-risk antenatal care unit over a 6-year period. A descriptive analysis of morphological findings was performed of the placenta when pathology reports were available. Results: Sixty-two SCD pregnant women [25 Hb SS (40 %), 29 Hb SC (47 %) and 8 Hb Sβ (13 %)] were included. Overall, SCD was associated with maternal complications (77 %), preterm birth (30 %), cesarean section (80 %) and a need of blood transfusion. In general there were no statistically significant differences between genotypes. The only significant difference was the hemoglobin level at first antenatal care visit which was lower for the homozygous genotype (7.7 g/dL) compared to Hb SC and Hb Sβ (9.7 g/dL and 8.4 g/dL, respectively; p-value = 0.01). Ten of 15 evaluated placentas showed abnormal morphological findings Conclusion: SCD, regardless of the underlying genotype, is associated with increased adverse maternal and perinatal outcomes and placental abnormalities associated with maternal vascular malperfusion. |
| format | Article |
| id | doaj-art-ed26a7b0857b4d93b63a2e3a98e1292a |
| institution | Kabale University |
| issn | 2531-1379 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj-art-ed26a7b0857b4d93b63a2e3a98e1292a2024-12-01T05:07:44ZengElsevierHematology, Transfusion and Cell Therapy2531-13792024-11-0146S189S196Sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypesCamilla Olivares Figueira0José Paulo S. Guida1Fernanda G. Surita2Arthur Antolini-Tavares3Sara T. Saad4Fernando F. Costa5Kleber Y. Fertrin6Maria Laura Costa7Department of Obstetrics and Gynecology, State University of Campinas (UNICAMP), 101, Alexander Fleming St, Campinas, São Paulo 13084-881, BrazilDepartment of Obstetrics and Gynecology, State University of Campinas (UNICAMP), 101, Alexander Fleming St, Campinas, São Paulo 13084-881, BrazilDepartment of Obstetrics and Gynecology, State University of Campinas (UNICAMP), 101, Alexander Fleming St, Campinas, São Paulo 13084-881, BrazilDepartment of Pathological Anatomy, State University of Campinas (UNICAMP), 126, Tessália Vieira de Camargo St, Campinas, São Paulo 13083-887, BrazilDepartment of Hematology and Hemotherapy, State University of Campinas (UNICAMP), 126, Tessália Vieira de Camargo St, Campinas, São Paulo 13083-887, BrazilDepartment of Hematology and Hemotherapy, State University of Campinas (UNICAMP), 126, Tessália Vieira de Camargo St, Campinas, São Paulo 13083-887, BrazilDivision of Hematology, Department of Medicine, University of Washington, WA 98195, Seattle, WA, USADepartment of Obstetrics and Gynecology, State University of Campinas (UNICAMP), 101, Alexander Fleming St, Campinas, São Paulo 13084-881, Brazil; Corresponding author at: Department of Obstetrics and Gynecology, The University of Campinas, 101 Alexander Fleming St; Campinas, SP.Background: Sickle cell disease (SCD) comprises a heterogeneous group of inherited hemolytic disorders that increases the risk of maternal and perinatal complications due to chronic systemic inflammatory response, endothelial damage and vaso-occlusion. The contribution of genotypes to the severity of outcomes during pregnancy is not completely established. Methods: A retrospective study of medical charts was performed to compare maternal and perinatal outcomes in Hb SS, Hb SC disease and sickle-beta thalassemia (Hb Sβ) pregnancies followed at a high-risk antenatal care unit over a 6-year period. A descriptive analysis of morphological findings was performed of the placenta when pathology reports were available. Results: Sixty-two SCD pregnant women [25 Hb SS (40 %), 29 Hb SC (47 %) and 8 Hb Sβ (13 %)] were included. Overall, SCD was associated with maternal complications (77 %), preterm birth (30 %), cesarean section (80 %) and a need of blood transfusion. In general there were no statistically significant differences between genotypes. The only significant difference was the hemoglobin level at first antenatal care visit which was lower for the homozygous genotype (7.7 g/dL) compared to Hb SC and Hb Sβ (9.7 g/dL and 8.4 g/dL, respectively; p-value = 0.01). Ten of 15 evaluated placentas showed abnormal morphological findings Conclusion: SCD, regardless of the underlying genotype, is associated with increased adverse maternal and perinatal outcomes and placental abnormalities associated with maternal vascular malperfusion.http://www.sciencedirect.com/science/article/pii/S2531137924000567Sickle cell diseasePregnancyTransfusionAnemiaPlacenta |
| spellingShingle | Camilla Olivares Figueira José Paulo S. Guida Fernanda G. Surita Arthur Antolini-Tavares Sara T. Saad Fernando F. Costa Kleber Y. Fertrin Maria Laura Costa Sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypes Hematology, Transfusion and Cell Therapy Sickle cell disease Pregnancy Transfusion Anemia Placenta |
| title | Sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypes |
| title_full | Sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypes |
| title_fullStr | Sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypes |
| title_full_unstemmed | Sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypes |
| title_short | Sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypes |
| title_sort | sickle cell disease and increased adverse maternal and perinatal outcomes in different genotypes |
| topic | Sickle cell disease Pregnancy Transfusion Anemia Placenta |
| url | http://www.sciencedirect.com/science/article/pii/S2531137924000567 |
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