RESUMO
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 the dockets, kept at 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 percent. There was a significant increased risk of perinatal death with low maternal fetal haemoglobin level, but there was no haematological associations with miscarriages or birthweight. CONCLUSIONS: These data suggest that maternal steady-state haemoglobin 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. (AU)
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Adolescente , Adulto , Anemia Falciforme/sangue , Hemoglobina Fetal/análise , Hemoglobinas/análise , Complicações Hematológicas na Gravidez/sangue , Aborto/sangue , Anemia Falciforme/mortalidade , Peso ao Nascer , Morte Fetal , Complicações Hematológicas na Gravidez/mortalidade , Estudos Retrospectivos , Fatores de RiscoRESUMO
The outcome of 664 pregnancies in 297 Jamaican women with homozygous sickle cell (SS) disease during the period 1959-84 was reviewed. Overall, the spontaneous abortion rate was 118/1000 pregnancies, the stillbirth rate 128/1000 births, and perinatal mortality 171/1000 births. There was a striking secular increase in both spontaneous abortions and stillbirths accounted for, in part, by a trend for abortions to increase with maternal age up to the age of 30, a greater proportion of patients in the high-risk group, ages 25-29, occuring during 1980-84. Another factor contributing to the poor obstetric performance during the 1980-84 period was probably an increased survival and pregnancy rate in high-risk patients. 7 women had pregnancy-related deaths giving a pregnancy mortality rate of 1.1 percent.(AU)
