Women with sickle cell disease (SCD) are known to experience adverse pregnancy outcomes worldwide. This is also true in the United States, where black women are at significantly higher risk of poor maternal health compared to all other racial demographics.
To better understand the social role of maternal morbidity in patients with sickle cell disease, Oyebimpe Adesina, MD, Center for Oncology Hematology Outcomes Research and Training, Division of Hematology Oncology, Division of Hematology Oncology, Division of Hematology Oncology, Division of Hematology Oncology, Division of Hematology Oncology, Division of Hematology Oncology, Division of Hematology Oncology, Department of Hematology Oncology, the University of California Davis School of Medicine, and a. decided to evaluate the rate.
According to researchers, sickle cell disease has evolved from a diagnosis associated with childhood mortality to a chronic disease characterized by acute complications and lifelong cumulative morbidity. Public health efforts and treatment advances have improved the prognosis for this rare condition, but increased life expectancy highlights many areas that need attention in this population.
How does sickle cell disease affect maternal mortality?
Many Americans with sickle cell disease are now in their 40s and 50s, most of whom are African American or Hispanic. This comes with potential pregnancy complications, especially for pregnant women with sickle cell disease.
The physiological demands and metabolic stressors of pregnancy themselves carry some risk, but when combined with endothelial activation and cytokine-mediated inflammation exacerbating chronic hemolysis, microvascular occlusion, and hypercoagulability in sickle cell disease, these The risks are significant.
To estimate the cumulative incidence of pregnancy outcomes in black women with and without SCD, researchers based on data from the California Department of Health Access and Information from 1991 to 2019 were divided into age, insurance State, and Distressed Community Index (DCI) scores adjusted.
The likelihood of premature birth among black pregnant women with SCD was higher compared with women without SCD due to the use of government insurance and the risk of these women living in at-risk or deprived areas. and hospital births were also statistically higher in this population.
Pregnancy Outcomes in Patients with Sickle Cell Disease
Unfortunately, this population also has a significantly higher risk of sepsis, venous thromboembolism, and postpartum hemorrhage. It is especially at risk during the second and third trimesters of pregnancy and six weeks after giving birth.
After adjusting for sociodemographic factors, black women with sickle cell disease continued to perform statistically worse than black women without sickle cell disease. Although more research is needed to understand, the researchers called for more comprehensive education in reproductive health care and guidance on continuation of sickle cell medications during pregnancy.
Increased access to interdisciplinary perinatal care could certainly reduce the prevalence of sickle cell disease among pregnant women, according to researchers.
The study, “Pregnancy Outcomes in Women With Sickle Cell Disease in California,” American Journal of Hematology.