title: Pregnancy in patients with sickle cell disease: maternal and perinatal outcomes.
abstract: OBJECTIVE
  To compare obstetrical, hematological and neonatal outcomes of pregnant women with or without sickle cell disease (SCD).
  
  
  METHODS
  A prospective study of 60 pregnancies of 58 women with SCD (29 SCD-SS and 29 SCD-SC) compared with 192 pregnancies in 187 healthy pregnant women was carried out from January 2009 to August 2011.
  
  
  RESULTS
  Compared to controls, the SCD group had higher rate of preterm delivery (p < 0.001, OR = 4.96, 95% CI 2.57-9.59), higher cesarean rate (p < 0.001, OR = 5.00, CI 2.65-9.45), more frequent deep vein thrombosis (p = 0.003), and urinary infection (p = 0.001, OR = 3.31, CI 1.63-6.73), higher prevalence of small for gestational age babies (p = 0.019, OR = 2.66, CI 1.15-6.17), and more frequent baby admissions to progressive care unit (p < 0.001, OR = 4.89, CI 2.26-10.6). Maternal death rate was also higher among women with SCD (p = 0.056). All adverse events were more frequent in the SS subgroup. Babies from the SS subgroup had the lowest weight at birth (2080 g) compared to SC (2737 g; p < 0.001) and controls (3035 g). A multivariate analysis confirmed painful episodes and SS genotype as factors contributing to preterm delivery.
  
  
  CONCLUSIONS
  SCD pregnant women - especially those in the SS subgroup - are more prone to experience perinatal and maternal complications in comparison with pregnant women without SCD.
authors.affiliation: Hospital Odilon Behrens , Belo Horizonte , Brasil .
authors.forename: Vanessa Maria Fenelon
authors.initials: VM
authors.lastname: Costa
authors.forename: Marcos Borato
authors.initials: MB
authors.lastname: Viana
authors.forename: Regina Amélia Lopes Pessoa
authors.initials: RA
authors.lastname: Aguiar
mesh_terms: D000755:Anemia, Sickle Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D010146:Pain / Q000150:complications / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D020246:Venous Thrombosis / Q000453:epidemiology
keywords: Acute chest syndrome; albuminuria; hemoglobin SC; preterm delivery; sickle cell anemia