Publication Date:
2010-11-19
Description:
Abstract 2661 Background: Patients with sickle cell disease (SCD) develop accumulating organ damage throughout their lives as result of chronic hemolytic anemia and ongoing microvascular vaso-occlusion. Chronic organ damage has been related to significant morbidity and increased mortality. Previous studies have shown significant increased foetal and maternal complications in patients with SCD. It is unclear whether the presence of chronic organ damage is related to pregnancy complications in these patients. Therefore, we determined the relation between chronic organ damage and pregnancy complications in women with SCD. Methods: We performed a retrospective analysis of pregnancy complications in all women known with SCD (defined as HbSS, HbS-β°, HbSC and HbSβ+) in a teaching hospital in the Netherlands. Pregnancy complications consisted of: hypertension, (pre)eclampsia, still birth, preterm birth, dysmaturity, urinary tract infection, perinatal mortality, maternal mortality, painful crisis and acute chest syndrome (ACS). In all patients vaso-occlusion related organ damage (pain rate 〉1 crises/year, ACS, avascular osteonecrosis and retinopathy) as well as hemolysis related organ damage (microalbuminuria, renal failure, pulmonary hypertension, chronic leg ulcers, stroke and cholelithiasis) was assessed. The patients were divided in a severe (HbSS/HbSβ°) and a mild genotype group (HbSC/HbSβ+). Chronic organ damage and the history of previous sickle cell-related complications were related to pregnancy complications, birth weight and laboratory tests. We adjusted for multiple pregnancies with the generalized estimated equations (GEE) model. Results: All 97 female patients known with SCD in our hospital were systematically evaluated for organ damage and sickle cell related complications. Thirty-six patients had not been pregnant at time of evaluation, medical information about their pregnancy was missing for 7 women and 6 women were only known with an elective abortion. Fifty-five pregnancies in 48 women with SCD (18 HbSS, 4 HbSβ0, 21 HbSC and 5 HbSβ+) were evaluated for pregnancy complications. Hemolysis related organ damage was present in 17/22 (77%) of the patients with a severe genotype and 7/32 (22%) patients with a mild genotype (p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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