Effect of Homozygous Sickle Cell Anemia on Perinatal Outcomes: A Retrospective Cohort Study

Backgrounds: Sickle cell anemia (SCA) is a multisystemic disorder that causes hemolytic anemia and impaired tissue perfusion due to sickling of red blood cells. Although there is a belief that adverse perinatal outcomes are frequent in pregnant women with SCA, this association has not been clearly established. The aim of this study was to compare the perinatal outcomes of women with homozygous mutated SCA who gave birth with those without the mutation. Methods: The study included 26 SCA patients with homozygous mutation and 108 pregnant women without mutation who gave birth in our center. Demographic and obstetric data, laboratory findings, and fetal findings of both groups were compared. Results: Statistically significant differences were found between the groups in terms of maternal age, body mass index (BMI), gravida, and parity (p <= 0.001, p = 0.035, p <= 0.001, p <= 0.001, respectively). Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red blood cell count (RBC), hemoglobin (Hb), and hematocrit (Hct) values were significantly lower in the SCA group. We also observed that more blood transfusions were performed during pregnancy and the postpartum period in the SCA group. Low birth weight, more neonatal intensive care unit admissions, and a higher cesarean section rate were present in the SCA group. During pregnancy, women with SCA were most frequently admitted to the hospital for acute painful crises. Preeclampsia was not more common in the SCA group. Conclusions: SCA carries serious risks for the mother and fetus during pregnancy. Therefore, the relationship between the disease and pregnancy requires more detailed research.