title: Impact of sickle cell disease and thalassemias in infants on birth outcomes.
abstract: OBJECTIVE
  The contribution of sickle cell disease (SCD) and other common thalassemias in infants to adverse birth outcomes is under-studied. We therefore sought to compare adverse birth outcomes in infants with and without hemoglobinopathy.
  
  
  METHODS
  Retrospective cohort study utilizing a population-based dataset from Florida (1998-2007, n=1,564,038). The primary outcomes were low birthweight (LBW), very low birthweight (VLBW), preterm birth (PTB), very preterm birth (VPTB) and small for gestational age (SGA). We used propensity scores to match infants with hemoglobinopathy to those without hemoglobinopathy on selected variables. To approximate relative risks, we generated adjusted odds ratios (AOR) and 95% confidence intervals (CI) from logistic regression models and accounted for the matched design using generalized estimating equations framework.
  
  
  RESULTS
  Infants with SCD or thalassemia had a heightened risk for LBW (AOR=1.58, 95% CI: 1.29-1.93), VLBW (AOR=3.01, 95% CI: 2.12-4.25), PTB (AOR=1.36, 95% CI: 1.12-1.65), VPTB (AOR=2.70, 95% CI: 1.93-3.78), and neurological conditions (AOR=2.04, 95% CI: 1.48-2.81) compared to infants without hemoglobinopathy.
  
  
  CONCLUSIONS
  Infants with SCD or thalassemia experience considerably higher risks for multiple infant morbidities. Our findings are potentially important in prenatal counseling, as well as for targeted care of affected pregnancies in the prenatal period.
authors.affiliation: University of South Florida, College of Medicine, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Tampa, FL, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Whiteman
authors.forename: Abraham
authors.initials: A
authors.lastname: Salinas
authors.forename: Hanna E
authors.initials: HE
authors.lastname: Weldeselasse
authors.forename: Euna M
authors.initials: EM
authors.lastname: August
authors.forename: Alfred K
authors.initials: AK
authors.lastname: Mbah
authors.forename: Muktar H
authors.initials: MH
authors.lastname: Aliyu
authors.forename: Hamisu M
authors.initials: HM
authors.lastname: Salihu
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000453:epidemiology*; D002493:Central Nervous System Diseases / Q000151:congenital / Q000453:epidemiology*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies; D013789:Thalassemia / Q000453:epidemiology*
keywords: Birth outcomes; Hemoglobinopathy; Pregnancy; Sickle cell; Thalassemia