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Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy - a balance of risks for aspirin?
Gibson, Shanea M P; Hunter, Tiffany A; Charles, Phillip E; Morgan, Melonie A C; Griffith-Anderson, Shari K R; Cruickshank, J Kennedy; Gossell-Williams, Maxine D; Johnson, Nadine A.
Afiliación
  • Gibson SMP; Department of Obstetrics and Gynaecology, 233759 University Hospital of the West Indies , Mona, Jamaica.
  • Hunter TA; Department of Obstetrics and Gynaecology, 233759 University Hospital of the West Indies , Mona, Jamaica.
  • Charles PE; Department of Obstetrics and Gynaecology, 62707 University of the West Indies , Mona, Jamaica.
  • Morgan MAC; Department of Obstetrics and Gynaecology, 233759 University Hospital of the West Indies , Mona, Jamaica.
  • Griffith-Anderson SKR; Department of Obstetrics and Gynaecology, 62707 University of the West Indies , Mona, Jamaica.
  • Cruickshank JK; Department of Obstetrics and Gynaecology, 62707 University of the West Indies , Mona, Jamaica.
  • Gossell-Williams MD; Department of Obstetrics and Gynaecology, 233759 University Hospital of the West Indies , Mona, Jamaica.
  • Johnson NA; Department of Obstetrics and Gynaecology, 62707 University of the West Indies , Mona, Jamaica.
J Perinat Med ; 52(5): 485-493, 2024 Jun 25.
Article en En | MEDLINE | ID: mdl-38629833
ABSTRACT

OBJECTIVES:

Sickle cell disease (SCD) occurs in 2.8 % of our Jamaican antenatal population with homozygous HbSS being most associated with adverse maternal and perinatal outcomes.

METHODS:

A retrospective comparative analysis of HbSS, HbSC and HbSßThal pregnancy outcomes at the University Hospital of the West Indies (UHWI) between January 2012 and December 2022 was conducted.

RESULTS:

Of 120 patients (138 pregnancies), obesity occurred in 36 % (20/56) of the 'non-HbSS' group, i.e. HbSßThal (55 %, 5/9) and HbSC (32 %, 15/47) combined vs. 9.7 % of the HbSS (8/82). HbSS patients had more crises requiring transfusions, acute chest syndrome (ACS), maternal 'near-misses' (OR=10.7, 95 % 3.5-32.3; p<0.001), hospitalizations (OR 7.6, 95 % CI 3.4-16.9; p<0.001), low birth weight (LBW) neonates (OR 3.1, 1.1-8.9; p=0.037) and preterm birth (OR=2.6, 1.2-5.8; p=0.018) compared to HbSC and HbSßThal. Low dose aspirin was prescribed in 43 %. Logistic regression showed those NOT on aspirin (n=76) had more miscarriages (22 v. 2 %), were LESS likely to have a live birth (75 v. 95 % (0.2, 0.04-0.57, p=0.005)), but surprisingly had fewer painful crises (28 v. 46 % (0.5, 0.03-0.9, p=0.03)).

CONCLUSIONS:

HbSS women had a 10-fold excess of maternal near-misses. Additional research may further clarify the effects of aspirin on pregnancy outcomes as related to SCD genotypes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Hematológicas del Embarazo / Resultado del Embarazo / Aspirina / Anemia de Células Falciformes Límite: Adult / Female / Humans / Newborn / Pregnancy País/Región como asunto: Caribe ingles / Jamaica Idioma: En Revista: J Perinat Med Año: 2024 Tipo del documento: Article País de afiliación: Jamaica Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Hematológicas del Embarazo / Resultado del Embarazo / Aspirina / Anemia de Células Falciformes Límite: Adult / Female / Humans / Newborn / Pregnancy País/Región como asunto: Caribe ingles / Jamaica Idioma: En Revista: J Perinat Med Año: 2024 Tipo del documento: Article País de afiliación: Jamaica Pais de publicación: Alemania