HEMATOLOGICAL RISK-FACTORS FOR PREGNANCY OUTCOME IN JAMAICAN WOMEN WITH HOMOZYGOUS SICKLE-CELL DISEASE

Objective To examine the association between fetal outcome and the ste ady state haematology of mothers with homozygous sickle cell disease. Design A retrospective observational study. The data were taken from d ockets kept at the Sickle Cell Clinic and verified by interview with 4 5 % of the patients. Setting The Sickle Cell Clinic at the University Hospital of the West Indies or two peripheral clinics operated by the staff of the MRC Laboratories. Subjects All women aged 14 years or old er with homozygous sickle cell disease who had experienced at least on e pregnancy in the period 1977 to 1986. Main outcome measures Three fe tal outcomes including miscarriages, perinatal deaths, and birthweight . Results There were 270 singleton pregnancies in 175 women with an ov erall fetal wastage of 32.2 %. There was a significant increased risk of perinatal death with low maternal fetal haemoglobin level, but ther e were no haematological associations with miscarriages or birthweight . Conclusions These data suggest that maternal steady-state haematolog y has little influence on fetal outcome, with the exception that mothe rs with high HbF levels are less prone to perinatal deaths. Further st udy is required to investigate acute haematological changes associated with pregnancy.