title: Pregnant women with the sickle cell trait are not at increased risk for developing preeclampsia.
abstract: The primary objective of this study was to determine whether having the sickle cell trait is independently associated with preeclampsia. We performed a retrospective cohort study of 1998 pregnant patients who either did or did not have the sickle cell trait. All patients were screened for the sickle trait using the "Sickledex" test. Data on neonatal and maternal outcome, including preeclampsia, and potential confounding variables were abstracted from medical records. Unadjusted, stratified, and multiple logistic regression analyses were used to identify interactions, and confounding between multiple variables and the association between sickle cell trait and preeclampsia. With an anticipated 6.5% rate of preeclampsia, and alpha = 0.05, this cohort study has 80% power to detect a relative risk (RR) of 2.3 for preeclampsia. Univariate analysis revealed that the two cohorts were similar with regard to primiparity, maternal age, chronic diseases, birth weight, and gestational age at delivery, but the sickle cell trait cohort was more likely to have gestational diabetes and had a higher mean body mass index (BMI). In the univariate analysis, the sickle cell trait cohort was not at increased risk for preeclampsia [unadjusted RR = 0.5, 95% CI (0.2-1.6)]. After controlling for potential confounding variables with logistic regression analysis, sickle trait was not independently associated with preeclampsia [adjusted RR = 0.5, 95% CI (0.2- 1.6)]. In contrast to prior work, these data suggest that the sickle cell trait is not an independent risk factor for preeclampsia or postpartum complications. In fact, the data are more consistent with the sickle trait being protective for developing preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Stamilio
authors.forename: Harish M
authors.initials: HM
authors.lastname: Sehdev
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D016015:Logistic Models; D008499:Medical Records; D009765:Obesity; D015143:Philadelphia / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012805:Sickle Cell Trait / Q000150:complications*