Sickle cell disease in pregnancy: Twenty years of experience at Grady Memorial Hospital, Atlanta, Georgia

OBJECTIVE: We compared pregnancy outcomes among women with sickle cell dise ase with outcomes for African American women without the disease. STUDY DESIGN: We selected 127 deliveries in women with sickle cell disease (hemoglobin SS or hemoglobin SC) that occurred between 1980 and 1999. A con trol group of 129 deliveries by African American women with normal hemoglob in (hemoglobin AA) was also selected. Evaluated pregnancy outcomes included low birth weight, prematurity, intrauterine growth restriction, antepartum hospital admission, preterm labor or preterm premature rupture of membrane s, postpartum infection, preeclampsia, pyelonephritis, intrauterine fetal d eath, perinatal mortality, and maternal mortality. RESULTS: Compared with deliveries among women with hemoglobin AA, deliverie s among women with hemoglobin SS or hemoglobin SC were at increased risk fo r intrauterine growth restriction, antepartum hospital admission, and postp artum infection. In addition, deliveries among women with Hb SS were more l ikely to be complicated by low birth weight, prematurity, and preterm labor or preterm premature rupture of membranes when compared with deliveries am ong women with hemoglobin AA. There were no significant differences among t he groups (hemoglobin SS, hemoglobin SC, and hemoglobin AA) in terms of per inatal deaths; there were no maternal deaths in the study population. CONCLUSION: Those,caring for women with sickle cell disease should be aware that they are at increased risk for pregnancy complications, although over all pregnancy outcome is favorable.