title: [Maternal and perinatal outcomes in pregnancies complicated by sickle cell diseases].
abstract: OBJECTIVE
  the aim of this study was to describe perinatal and maternal outcomes of pregnancies complicated by sickle cell disease (SCD), comparing to pregnancies of women with sickle cell trait (SCT).
  
  
  METHODS
  this was a retrospective cohort study, covering the period from March 2001 to April 2008, which included all pregnant women with SCD (n=42) followed up at a university hospital in the Southeast region of Brazil. The maternal and perinatal outcomes were compared to those of pregnant women with SCT (n=56) who were followed up at the same service.
  
  
  RESULTS
  SCD-SS was diagnosed in 42 (82.4%) pregnant women and SC in 9 (17.6%). Mean (±SD) maternal age was significantly lower in the SCD group (26.0 years) compared to SCT women (28.7±7.1 years; p=0.018). The following maternal complications were more common among women with SCD in comparison to SCT: urinary tract infection (25.5 versus 8.9%; p=0.04), pneumonia (23.5 versus 1.8%; p=0.002), pulmonary hypertension (15.7 versus 0%; p=0.002), and blood transfusion during delivery or postpartum (33.3 versus 5.4%; p=0.001). Adverse perinatal outcome was more frequent in the SCD group compared to the SCT group: prematurity (49 versus 25%, p=0.01); mean gestational age at delivery (35.2 versus 37.9 weeks, p<0.001); fetal distress (56.9 versus 28.6%, p=0.006); birth weight <2,500 g (62.7 versus 17.9%, p<0.001); mean birth weight (2,183 versus 2,923 g, p<0.001), and small for gestational age infants (29.4 versus 10.7%, p=0.029). Two maternal deaths (3.9%) occurred in the group with SCD.
  
  
  CONCLUSIONS
  Pregnant women with SCD are at greater risk for maternal morbidity and for adverse perinatal outcomes than women with SCT.
authors.affiliation: Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo - USP, São Paulo, SP, Brasil.
authors.forename: Roseli Mieko Yamamoto
authors.initials: RM
authors.lastname: Nomura
authors.forename: Ana Maria Kondo
authors.initials: AM
authors.lastname: Igai
authors.forename: Karine
authors.initials: K
authors.lastname: Tosta
authors.forename: Guilherme Henrique Hencklain
authors.initials: GH
authors.lastname: da Fonseca
authors.forename: Sandra Fátima Menosi
authors.initials: SF
authors.lastname: Gualandro
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012805:Sickle Cell Trait