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CC BY-NC-ND 4.0 · AJP Rep 2019; 09(04): e346-e352
DOI: 10.1055/s-0039-1695743
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Adverse Pregnancy Outcomes in Women with Sickle Cell Trait[∗]

Whitney L. Wellenstein
1   Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Oakland, California
,
Shannon Sullivan
1   Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Oakland, California
,
Jeanne Darbinian
2   Division of Research, Kaiser Permanente Medical Center, Oakland, California
,
Miranda L. Ritterman Weintraub
3   Department of Graduate Medical Education, Kaiser Permanente Medical Center, Oakland, California
,
Mara Greenberg
1   Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Oakland, California
› Author Affiliations
Further Information

Publication History

08 March 2019

14 May 2019

Publication Date:
11 November 2019 (online)

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Erratum: Adverse Pregnancy Outcomes in Women with Sickle Cell TraitAJP Rep 2019; 09(04): e389-e389
DOI: 10.1055/s-0040-1701199

Abstract

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.

Keywords

adverse pregnancy outcomes in African American women - hemoglobinopathy in pregnancy - sickle cell trait

Financial Disclosures

None.


a University of Chicago/NorthShore University Health Systems, Department of Gynecology Oncology.


∗ ePoster presentation: 64th annual ACOG Clinical and Scientific Meeting, Washington DC, May 13, 2016


 

  • References

  • 1 Bryant AS, Worjoloh A, Caughey AB, Washington AE. Racial/ethnic disparities in obstetric outcomes and care: prevalence and determinants. Am J Obstet Gynecol 2010; 202 (04) 335-343
    CrossrefPubMedGoogle Scholar
  • 2 Oteng-Ntim E, Meeks D, Seed PT. , et al. Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis. Blood 2015; 125 (21) 3316-3325
    CrossrefPubMedGoogle Scholar
  • 3 Tita AT, Biggio JR, Chapman V, Neely C, Rouse DJ. Perinatal and maternal outcomes in women with sickle or hemoglobin C trait. Obstet Gynecol 2007; 110 (05) 1113-1119
    CrossrefPubMedGoogle Scholar
  • 4 Stamilio DM, Sehdev HM, Macones GA. Pregnant women with the sickle cell trait are not at increased risk for developing preeclampsia. Am J Perinatol 2003; 20 (01) 41-48
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Eichner ER. Sickle cell considerations in athletes. Clin Sports Med 2011; 30 (03) 537-549
    CrossrefPubMedGoogle Scholar
  • 6 Tsaras G, Owusu-Ansah A, Boateng FO, Amoateng-Adjepong Y. Complications associated with sickle cell trait: a brief narrative review. Am J Med 2009; 122 (06) 507-512
    CrossrefPubMedGoogle Scholar
  • 7 Larrabee KD, Monga M. Women with sickle cell trait are at increased risk for preeclampsia. Am J Obstet Gynecol 1997; 177 (02) 425-428
    CrossrefPubMedGoogle Scholar
  • 8 Gordon NP. Similarity of the adult Kaiser Permanente membership in Northern California to the insured and general population in Northern California: statistics from the 2011–12 California Health Interview Survey. Oakland, CA: Kaiser Permanente Division of Research. http://www.dor.kaiser.org/external/chis_non_kp_2011 . Published June 2015. Accesed February 1, 2017
    PubMedGoogle Scholar
  • 9 Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982; 144 (07) 768-773
    CrossrefPubMedGoogle Scholar
  • 10 Whalley PJ, Pritchard JA, Richards Jr JR. Sickle cell trait and pregnancy. JAMA 1963; 186: 1132-1135
    PubMedGoogle Scholar