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Maternal and infant outcomes in women with sickle cell disease: a matched cohort study
  1. Oishi Sikdar1,
  2. Hemant Ambulkar2,
  3. Allan Jenkinson1,
  4. Catherine Hedley3,
  5. Jemma Johns3,
  6. Ravindra Bhat2,
  7. Theodore Dassios1,2,
  8. Christopher Harris1,2,
  9. Anne Greenough1
  1. 1Department of Women and Children’s Health, King's College London, London, UK
  2. 2Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
  3. 3Department of Obstetrics and Gynaecology, King's College Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Professor Anne Greenough, Department of Women and Children’s Health, King's College London, London SE5 9RS, UK; anne.greenough{at}kcl.ac.uk

Abstract

Objective Women with sickle cell disease (SCD) have adverse maternal and infant outcomes. Our aim was to determine whether the outcomes of SCD mothers and their infants differed from African or Caribbean women not affected by SCD and whether there were differences between SCD individuals with the haemoglobin SS (HbSS) or haemoglobin SC (HbSC) genotypes. Furthermore, we wished to determine if any differences related to deprivation.

Design A matched cohort study.

Setting Tertiary perinatal centre in London

Patients 4964 African or Caribbean women without SCD and 148 with SCD.

Main outcome measures Mode of delivery, maternal exchange transfusion, birthweight, neonatal unit admission, neonatal death and deprivation indices

Results SCD women were more likely to be delivered by caesarean section (p<0.001) and had babies of lower birthweight (p<0.001). Their infants were no more likely to be admitted to neonatal intensive care unit or suffer a neonatal death. There were no significant differences between the SCD women and those without SCD in their deprivation index or deprivation decile. The women with the HbSS genotype compared to those with the HbSC genotype were more anaemic (p<0.02), required more exchange transfusions (p<0.001) and were more likely to be delivered by caesarean section (p=0.008). The infant outcomes did not differ significantly between the genotypes.

Conclusions Although, the SCD women, particularly those with the HbSS genotype, had greater morbidity, infant morbidity, and mortality was similar in mothers with the HbSS or HbSC genotypes and those without SCD.

  • Neonatology
  • Genetics

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/archdischild-2024-326848

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Presented at The results of this study were presented as an abstract at the Neonatal Society Autumn Meeting 2023.

    • Contributors AG, JJ and RB conceived the study. OS, HA, AL and CH collected the data. CH, TD and AG analysed the data. OS wrote the first draft. All authors approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer-reviewed.