Pregnancy in patients with sickle cell disease: maternal and perinatal outcomes.

Autor: Costa VM; Hospital Odilon Behrens , Belo Horizonte , Brasil ., Viana MB, Aguiar RA
Jazyk: angličtina
Zdroj: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2015 Apr; Vol. 28 (6), pp. 685-9. Date of Electronic Publication: 2014 Jun 26.
DOI: 10.3109/14767058.2014.928855
Abstrakt: Objective: To compare obstetrical, hematological and neonatal outcomes of pregnant women with or without sickle cell disease (SCD).
Methods: A prospective study of 60 pregnancies of 58 women with SCD (29 SCD-SS and 29 SCD-SC) compared with 192 pregnancies in 187 healthy pregnant women was carried out from January 2009 to August 2011.
Results: Compared to controls, the SCD group had higher rate of preterm delivery (p < 0.001, OR = 4.96, 95% CI 2.57-9.59), higher cesarean rate (p < 0.001, OR = 5.00, CI 2.65-9.45), more frequent deep vein thrombosis (p = 0.003), and urinary infection (p = 0.001, OR = 3.31, CI 1.63-6.73), higher prevalence of small for gestational age babies (p = 0.019, OR = 2.66, CI 1.15-6.17), and more frequent baby admissions to progressive care unit (p < 0.001, OR = 4.89, CI 2.26-10.6). Maternal death rate was also higher among women with SCD (p = 0.056). All adverse events were more frequent in the SS subgroup. Babies from the SS subgroup had the lowest weight at birth (2080 g) compared to SC (2737 g; p < 0.001) and controls (3035 g). A multivariate analysis confirmed painful episodes and SS genotype as factors contributing to preterm delivery.
Conclusion: SCD pregnant women - especially those in the SS subgroup - are more prone to experience perinatal and maternal complications in comparison with pregnant women without SCD.
Databáze: MEDLINE