Pregnancy outcomes among patients with sickle cell disease at Korle-Bu Teaching Hospital, Accra, Ghana: retrospective cohort study.
Pregnancy in sickle cell disease (SCD) patients is associated with increased risk of maternal and fetal mortality. This study determines pregnancy outcomes among women with SCD delivering at Korle-Bu Teaching Hospital, Accra, Ghana. Nine hundred sixty (960) medical records of pregnant women (131 HbSS, 112 HbSC, and 717 comparison group) from 2007 to 2008 were reviewed. The HbSS women were at increased risk of eclampsia (adjusted odds ratio [AOR] = 10.56, 95% confidence interval [CI] = 3.60-30.96, P < 0.001), intrauterine growth restriction (AOR = 4.00, 95% CI = 1.38-11.64, P = 0.011), and placenta previa (AOR = 22.03, 95% CI = 9.87-49.14, P < 0.001) compared with the comparison group. The HbSC women had increased risk for intrauterine fetal death (AOR = 3.38, 95% CI = 1.15-9.96, P = 0.027) and decreased risk of delivering low birth weight babies (AOR = 0.21, 95% CI = 0.06-0.73, P = 0.014). Women with SCD in Ghana are at a greater risk of morbidity and mortality in pregnancy compared with women without hemoglobinopathies. Improved maternal and fetal outcomes in Ghanaian women with SCD can be achieved through effective intervention by health care providers with thorough knowledge about predisposing factors toward adverse outcomes.
Morehouse School of Medicine, Department of Microbiology, Biochemistry and Immunology, Atlanta, GA 30310, USA. nwilson@msm.edu
Nana O
NO
Wilson
Fatou K
FK
Ceesay
Jacqueline M
JM
Hibbert
Adel
A
Driss
Samuel A
SA
Obed
Andrew A
AA
Adjei
Richard K
RK
Gyasi
Winston A
WA
Anderson
Jonathan K
JK
Stiles
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D001724:Birth Weight; D004461:Eclampsia; D005260:Female; D005313:Fetal Death / Q000097:blood; D005317:Fetal Growth Retardation / Q000097:blood / Q000453:epidemiology*; D005865:Gestational Age; D005869:Ghana / Q000453:epidemiology; D006784:Hospitals, Teaching; D006801:Humans; D016015:Logistic Models; D008428:Maternal Mortality; D015999:Multivariate Analysis; D010923:Placenta Previa / Q000097:blood / Q000453:epidemiology*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult