TY - JOUR
T1 - Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease
T2 - Systematic review and meta-analysis
AU - Oteng-Ntim, Eugene
AU - Meeks, Daveena
AU - Seed, Paul T.
AU - Webster, Louise
AU - Howard, Jo
AU - Doyle, Pat
AU - Chappell, Lucy C.
PY - 2015/5/21
Y1 - 2015/5/21
N2 - A systematic review and meta-analysis of observational studies were conducted to quantify the association between sickle cell disease in pregnancy and adverse maternal and perinatal outcomes. Data sources (Medline, Embase, Maternity and Infant care, Cochrane, Web of Science, Popline) were searched for publications to June 2014. Eligibility criteria included observational studies reporting maternal and perinatal health outcomes in pregnant women with sickle cell disease against a comparative group of pregnant women without sickle cell disease. Twenty-one studies, (including 26,349 women with sickle cell disease; 26,151,746 women without sickle cell disease) were eligible for inclusion. Pregnancies in women with HbSS genotype, compared to women without sickle cell disease, were at increased risk of maternal mortality (RR 5.98; 95%CI 1.94 to 18.44), pre-eclampsia (RR 2.43; 1.75 to 3.39), stillbirth (RR 3.94; 2.60 to 5.96), preterm delivery ((RR 2.21; 1.47 to 3.31) and small for gestational age infants (RR 3.72; 2.32 to 5.98). Meta-regression demonstrated that genotype (HbSS vs. HbSC), low gross national income and high study quality were associated with increased relative risks. Despite advances in the management of sickle cell disease, obstetrics and neonatal medicine, pregnancies complicated by the disease remain associated with increased risk of adverse maternal and perinatal outcomes.
AB - A systematic review and meta-analysis of observational studies were conducted to quantify the association between sickle cell disease in pregnancy and adverse maternal and perinatal outcomes. Data sources (Medline, Embase, Maternity and Infant care, Cochrane, Web of Science, Popline) were searched for publications to June 2014. Eligibility criteria included observational studies reporting maternal and perinatal health outcomes in pregnant women with sickle cell disease against a comparative group of pregnant women without sickle cell disease. Twenty-one studies, (including 26,349 women with sickle cell disease; 26,151,746 women without sickle cell disease) were eligible for inclusion. Pregnancies in women with HbSS genotype, compared to women without sickle cell disease, were at increased risk of maternal mortality (RR 5.98; 95%CI 1.94 to 18.44), pre-eclampsia (RR 2.43; 1.75 to 3.39), stillbirth (RR 3.94; 2.60 to 5.96), preterm delivery ((RR 2.21; 1.47 to 3.31) and small for gestational age infants (RR 3.72; 2.32 to 5.98). Meta-regression demonstrated that genotype (HbSS vs. HbSC), low gross national income and high study quality were associated with increased relative risks. Despite advances in the management of sickle cell disease, obstetrics and neonatal medicine, pregnancies complicated by the disease remain associated with increased risk of adverse maternal and perinatal outcomes.
UR - http://www.scopus.com/inward/record.url?scp=84929998848&partnerID=8YFLogxK
U2 - 10.1182/blood-2014-11-607317
DO - 10.1182/blood-2014-11-607317
M3 - Article
C2 - 25800049
SN - 0006-4971
VL - 125
SP - 3316
EP - 3325
JO - Blood
JF - Blood
IS - 21
ER -