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Adverse clinical and obstetric outcomes among pregnant women with different sickle cell disease genotypes

2018; Elsevier BV; Volume: 143; Issue: 1 Linguagem: Inglês

10.1002/ijgo.12626

1879-3479

Flávia A. C. Silva, Ana Laura Carneiro Gomes Ferreira, Manuela Costa, Marina L.G. Dias, Aderson S. Araújo, Ariani Impieri de Souza,

Prenatal Screening and Diagnostics

Abstract Objective To compare clinical and obstetric adverse events among pregnant women with sickle cell disease ( SCD ) according to genotype. Methods The present cross‐sectional study enrolled women aged 15–49 years with SCD and prior pregnancy attending a hematology center in Recife, Brazil, between September 1, 2015, and April 30, 2016. Associations between sickle cell genotype (Hb SS , Hb SC , Sβ‐thalassemia) and adverse events were evaluated. Results Overall, 89 women were included; 74 (83%) had Hb SS genotype, 8 (9%) had Hb SC genotype, and 7 (8%) had Sβ‐thalassemia genotype. Fifty‐three (60%) self‐reported being of mixed race, and 27 (30%) self‐reported they were black. Blood transfusion was observed more frequently among women with Hb SS than among those with Hb SC genotype ( P =0.007). Postpartum adverse events were more frequent in the Sβ‐thalassemia than in the Hb SS group ( P =0.030). Fetal intrauterine death occurred only among women with the Hb SS genotype (11 [15%]). In the Hb SS group, there was a higher frequency of blood transfusion ( P =0.004) and lower rate of spontaneous abortion ( P =0.001) among women with six or more consultations. Conclusion The Hb SS genotype was associated with a higher frequency of blood transfusion. Sβ‐thalassemia was associated with a higher frequency of postpartum adverse events. Prenatal care was associated with a lower rate of spontaneous abortion in the Hb SS group.