scholarly journals Adverse Pregnancy Outcomes in Women with Sickle Cell Trait

2019 ◽  
Vol 09 (04) ◽  
pp. e346-e352
Author(s):  
Whitney L. Wellenstein ◽  
Shannon Sullivan ◽  
Jeanne Darbinian ◽  
Miranda L. Ritterman Weintraub ◽  
Mara Greenberg
Keyword(s):  
Sickle Cell ◽  
Pregnancy Outcomes ◽  
Sickle Cell Trait ◽  
Adverse Pregnancy Outcomes ◽  
P Value ◽  
Kaiser Permanente ◽  
Multivariable Analyses ◽  
Race Ethnicity ◽  
Adverse Pregnancy ◽  
Racial Ethnic

Objective To compare adverse pregnancy outcomes between women with sickle cell trait (SCT) and women with normal hemoglobin. Study Design A retrospective cohort study of women who delivered within Kaiser Permanente Northern California between 2006 and 2013. Using hemoglobin electrophoretic profiles, we defined women with hemoglobin AS (HbAS) as having SCT and those with hemoglobin AA (HbAA) as having normal hemoglobin. Outcomes were pregnancy-induced hypertension (PIH), small for gestational age (SGA), gestational diabetes (GDM), and preterm delivery (PTD). Demographic and pregnancy outcome variations were assessed in bivariate analyses. Multivariable logistic regression modeling was used to estimate odds ratios for the association between primary outcomes and selected characteristics. Results Of 31,840 eligible women, 868 (2.7%) had SCT. Women with SCT were more likely to have PIH (15.6% vs. 12.2%, p value = 0.003) and SGA (8.3% vs. 6.1%, p value = 0.008), less likely to have GDM (6.8% vs. 9.8%, p value = 0.003) and had similar PTD prevalence (8.1% vs. 7.6%, p value = 0.600). In multivariable analyses, SCT was not an independent predictor of these outcomes. Racial/ethnic minorities had higher adjusted odds of PIH, SGA, and GDM. Conclusion SCT alone does not appear to be associated with adverse pregnancy outcomes. Race/ethnicity is a risk factor for adverse pregnancy outcomes.

scholarly journals Erratum: Adverse Pregnancy Outcomes in Women with Sickle Cell Trait

2019 ◽  
Vol 09 (04) ◽  
pp. e389-e389
Author(s):  
Whitney L. Wellenstein ◽  
Shannon Sullivan ◽  
Jeanne Darbinian ◽  
Miranda L. Ritterman Weintraub ◽  
Mara Greenberg
Keyword(s):  
Sickle Cell ◽  
Pregnancy Outcomes ◽  
Sickle Cell Trait ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

Does Sickle Cell Trait Affect Adverse Pregnancy Outcomes? [20A]

2016 ◽  
Vol 127 ◽  
pp. 16S
Author(s):  
Uzma F. Naeem ◽  
Luis M. Gomez ◽  
Logan K. Williams ◽  
Danielle L. Tate ◽  
Rebecca A. Uhlmann
Keyword(s):  
Sickle Cell ◽  
Pregnancy Outcomes ◽  
Sickle Cell Trait ◽  
Adverse Pregnancy Outcomes ◽  
Trait Affect ◽  
Adverse Pregnancy

Multivariable Prediction Models for Adverse Pregnancy Outcomes in Sickle Cell Disease

2020 ◽  
Author(s):  
Ann Kinga Malinowski ◽  
Kevin H. M. Kuo ◽  
George A. Tomlinson ◽  
Patricia Palcu ◽  
Richard Ward ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Pregnancy Outcomes ◽  
Prediction Models ◽  
Adverse Pregnancy Outcomes ◽  
Cell Disease ◽  
Adverse Pregnancy

Adverse Pregnancy Outcomes In High Risk Sickle Cell Women

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2218-2218
Author(s):  
Pankhoori Saraf ◽  
Sari H Jacoby ◽  
Shailja Shah ◽  
Habib Nazir ◽  
Martin Gimovsky ◽  
...  
Keyword(s):  
High Risk ◽  
Sickle Cell ◽  
Pregnancy Outcomes ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Adverse Pregnancy Outcomes ◽  
Acute Chest Syndrome ◽  
Childbearing Age ◽  
Fetal Outcomes ◽  
Adverse Pregnancy

Abstract Background Life expectancy in patients with sickle cell disease (SCD) has increased with the institution of newborn screening, antibiotics and Hydroxyurea (HU). Prior studies have reported maternal mortality rate to be 2.2 times that of normal pregnancies. With improved high risk obstetrical services and hematological care, more women with SCD are choosing to carry a pregnancy (P). In order to see if outcomes have improved, we performed a review of women with SCD who had recent P at our hospital with a focus on maternal and fetal outcomes. Methods Patients (pts) were identified by a chart review of all women of childbearing age followed at both the Comprehensive Sickle Cell Center and the high risk obstetrics clinic. Data included: genotypes of SCD, fetal complications, P outcomes, transfusions (T), hospital admissions, previous HU use. Results 71 pregnancies were identified in 53 women from 2008 to 2013. Pregnancy outcomes See Table 1. Live births rates were equal in both GR I and GR II. The mean gestational age (weeks) in GR I was 35.13 and GR II 38.28 (p=0.0077) with more preterm births in GR I 16/36 (44%) compared to GR II 2/18 (11%). The most common mode of delivery was C-section in both GR I and II. Reasons for C- section were fetal distress 60% (20), repeat C-section 27% (9), other (5% or less) for breech, elective, preeclampsia, placenta previa. There were equal numbers of induced and spontaneous labor in each group. Complications in GR I 8/36 (22%) and GR II 2/18(11%) included PIH, Chorioamniotis, placenta previa, death (cardiac arrest). Fetal outcomes Low birth weight occurred in 20/33(61%) of GR I and 3/18(17%) of GR II (p= 0.0016) births. Other complications (41 % of births) including IUGR, meconium aspiration, oligohydramnios and Apgar scores <7 @ 1 min occurred equally in both GRs. Maternal outcomes: During P mean values for events in GR I and GR II respectively were: transfusions 5.56 units (U) and 1.22 U (p=0.0022), admission for vasoocclusive crisis (VOC) 3.33/pt and 1.44/pt (p=0.0173). Other complications were urinary tract infection (7), pneumonia (4), acute chest syndrome (4), cardiomyopathy (1), renal failure (1), hepatic crisis (2), DVT (1). Six patients were on HU pre- pregnancy (PP). In these patients 13 simple blood T were required PP and 56 during P (p=0.0297). VOC events increased from 13 PP to 35 during P (p=0.1011). 2 patient required exchange T during P. Conclusion Despite improved antenatal care for SCD women, P remains a high risk event for mother and fetus, with lower birth weights and more preterm deliveries in SS/SB 0 thal pts compared to SC/SB+ thal. Prior use of HU PP was not protective. New insights and studies are warranted to understand the pathophysiology of SCD causing adverse pregnancy outcomes and possible effects of HU withdrawal. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Geographic Distribution of Households with Goats and Women’s Adverse Pregnancy Outcomes and Perceptions of Healthcare Providers Toward Risk of Exposure to Goats or Their Raw Products in Pregnant Women

2019 ◽  
Author(s):  
Kan Kledmanee ◽  
Tippawan Liabsuetrakul
Keyword(s):  
Pregnant Women ◽  
Geographic Distribution ◽  
Pregnancy Outcomes ◽  
Healthcare Providers ◽  
Adverse Pregnancy Outcomes ◽  
P Value ◽  
Risk Screening ◽  
Risk Of Exposure ◽  
Cues To Action ◽  
Adverse Pregnancy

Objective: To identify the geographic distribution of households with goats and rates of adverse pregnancy outcomes in women, and assess healthcare providers’ perceptions towards risk of adverse pregnancy outcomes related with exposure to goats or their raw products during pregnancy and their intention to do risk screening.Material and Methods: A cross-sectional study was conducted in Songkhla province using the number of households with goats and the rates of abortion, stillbirth, and preterm birth reported in the Thailand 2015 Universal Coverage Scheme database. The perceptions towards risk of exposure to goats or their raw products and the intention to do risk screening according to the Health Belief Model of 46 healthcare providers from four districts of this province were using correlation analysis and multiple linear regression.Results: A high number of households with goats was found in all four districts but the number of households with goats was not significantly correlated with any of the rates of adverse pregnancy outcomes. Most perceptions of healthcare providers were highly correlated with intention to do risk screening, except their perceptions on barriers. Cues to action was significantly (p-value=0.018) associated with intention to do risk screening in multiple regression analysis.Conclusion: No correlation between the number of households with goats and rates of adverse pregnancy outcomes were found; however, healthcare providers had positive perceptions and intention to do risk screening for exposure to goats or their raw products in pregnant women. Education and warning messages concerning zoonosis as strengthening cues to action are needed.

scholarly journals Influence of maternal occupation on adverse pregnancy outcomes in a Nigerian tertiary health facility

2021 ◽  
Vol 8 (7) ◽  
pp. 3262
Author(s):  
Hope O. Nwoga ◽  
Miriam O. Ajuba ◽  
Chukwuma P. Igweagu
Keyword(s):  
Health Facility ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Still Birth ◽  
Chi Square Test ◽  
Maternal Occupation ◽  
Adverse Pregnancy

Background: There is accumulating evidence that the type of work and environmental exposures in the work environment during pregnancy may have adverse effects on fetal development and pregnancy outcome. The objective was to determine the influence of maternal occupation on adverse pregnancy outcomes.Methods: The study was a prospective hospital based study conducted at the obstetrics and gynecology department of a tertiary health facility in Nigeria. All the data were retrieved from the ante natal and delivery card of all the women that delivered at the unit within the time of data collection. Data was analyzed using SPSS version 25 and variables were presented as frequencies, percentages, means, and standard deviation. Bivariate analysis was done using chi-square test. The level of significance was set at p value ≤ 0.05.Results: Maternal occupation did not significantly affect the gestational age at delivery (X2=10.143, p=0.428) and birth weight (X2=16.807, p=0.079) however, it significantly affected the still birth (X2=28.134, p=0.002). Agricultural, forestry and fishery workers and plant and machine operators were about 8 times and 17 times more likely to have still birth than the unemployed respectively.Conclusions: There were substantial differences in the risk of adverse pregnancy outcomes between the different occupational groups.

scholarly journals Impact of Chronic Hypertension and Antihypertensive Treatment on Adverse Perinatal Outcomes: Systematic Review and Meta‐Analysis

2021 ◽  
Vol 10 (9) ◽  
Author(s):  
Sukainah Y. Al Khalaf ◽  
Éilis J. O'Reilly ◽  
Peter M. Barrett ◽  
Debora F. B. Leite ◽  
Lauren C. Pawley ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Antihypertensive Treatment ◽  
Severe Hypertension ◽  
Meta Analysis ◽  
Perinatal Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Chronic Hypertension ◽  
Race Ethnicity ◽  
Adverse Pregnancy ◽  
Maternal Race

Background Maternal chronic hypertension is associated with adverse pregnancy outcomes. Previous studies examined the association between either chronic hypertension or antihypertensive treatment and adverse pregnancy outcomes. We aimed to synthesize the evidence on the effect of chronic hypertension/antihypertensive treatment on adverse pregnancy outcomes. Methods and Results Medline/PubMed, EMBASE, and Web of Science were searched; we included observational studies and assessed the effect of race/ethnicity, where possible, following a registered protocol (CRD42019120088). Random‐effects meta‐analyses were used. A total of 81 studies were identified on chronic hypertension, and a total of 16 studies were identified on antihypertensive treatment. Chronic hypertension was associated with higher odds of preeclampsia (adjusted odd ratio [aOR], 5.43; 95% CI, 3.85–7.65); cesarean section (aOR, 1.87; 95% CI, 1.6–2.16); maternal mortality (aOR, 4.80; 95% CI, 3.04–7.58); preterm birth (aOR, 2.23; 95% CI, 1.96–2.53); stillbirth (aOR, 2.32; 95% CI, 2.22–2.42); and small for gestational age (SGA) (aOR, 1.96; 95% CI, 1.6–2.40). Subgroup analyses indicated that maternal race/ethnicity does not influence the observed associations. Women with chronic hypertension on antihypertensive treatment (versus untreated) had higher odds of SGA (aOR, 1.86; 95% CI, 1.38–2.50). Conclusions Chronic hypertension is associated with adverse pregnancy outcomes, and these associations appear to be independent of maternal race/ethnicity. In women with chronic hypertension, those on treatment had a higher risk of SGA, although the number of studies was limited. This could result from a direct effect of the treatment or because severe hypertension during pregnancy is a risk factor for SGA and women with severe hypertension are more likely to be treated. The effect of antihypertensive treatment on SGA needs to be further tested with large randomized controlled trials.

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