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Haematological risk factors for pregnancy outcome in Jamaican women with homozygous sickle cell disease


Correspondence: Ms J. Morris, Tropical Health Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.


Objective To examine the association between fetal outcome and the steady state haematology of mothers with homozygous sickle cell disease.

Design A retrospective observational study. The data were taken from dockets kept at the Sickle Cell Clinic and verified by interview with 45% 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 older with homozygous sickle cell disease who had experienced at least one pregnancy in the period 1977 to 1986.

Main outcome measures Three fetal outcomes including miscarriages, perinatal deaths, and birthweight.

Results There were 270 singleton pregnancies in 175 women with an overall fetal wastage of 32.2%. There was a significant increased risk of perinatal death with low maternal fetal haemoglobin level, but there were no haematological associations with miscarriages or birthweight.

Conclusions These data suggest that maternal steady-state haematology has little influence on fetal outcome, with the exception that mothers with high HbF levels are less prone to perinatal deaths. Further study is required to investigate acute haematological changes associated with pregnancy.