Sickle cell disease in pregnancy: twenty years of experience at Grady Memorial Hospital, Atlanta, Georgia.
OBJECTIVE
We compared pregnancy outcomes among women with sickle cell disease with outcomes for African American women without the disease.


METHODS
We selected 127 deliveries in women with sickle cell disease (hemoglobin SS or hemoglobin SC) that occurred between 1980 and 1999. A control group of 129 deliveries by African American women with normal hemoglobin (hemoglobin AA) was also selected. Evaluated pregnancy outcomes included low birth weight, prematurity, intrauterine growth restriction, antepartum hospital admission, preterm labor or preterm premature rupture of membranes, postpartum infection, preeclampsia, pyelonephritis, intrauterine fetal death, perinatal mortality, and maternal mortality.


RESULTS
Compared with deliveries among women with hemoglobin AA, deliveries among women with hemoglobin SS or hemoglobin SC were at increased risk for intrauterine growth restriction, antepartum hospital admission, and postpartum infection. In addition, deliveries among women with Hb SS were more likely to be complicated by low birth weight, prematurity, and preterm labor or preterm premature rupture of membranes when compared with deliveries among women with hemoglobin AA. There were no significant differences among the groups (hemoglobin SS, hemoglobin SC, and hemoglobin AA) in terms of perinatal deaths; there were no maternal deaths in the study population.


CONCLUSIONS
Those caring for women with sickle cell disease should be aware that they are at increased risk for pregnancy complications, although overall pregnancy outcome is favorable.
Sun
P M
PM
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Wilburn
W
W
Raynor
B D
BD
Jamieson
D
D
D000328:Adult; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D036861:Delivery, Obstetric; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007744:Obstetric Labor Complications / Q000453:epidemiology; D049590:Postpartum Period; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000706:statistics & numerical data; D012016:Reference Values; D012307:Risk Factors