Morbidity and pregnancy outcomes associated with sickle cell anemia among Saudi women

Objective: To identify morbidity and pregnancy outcomes associated with sickle cell disease (SCD) among pregnant Saudi women. Methods: A 10-year retrospective study was conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, that included 392 cases of SCD in pregnancy and 784 controls with normal hemoglobin phenotype, who were selected and matched for age, parity, and delivery outcome. The main outcome measures were morbidity, maternal outcomes, and fetal outcomes. Results: The incidence of SCD was 1.1% among all deliveries, with 2 maternal deaths (0.5%) and a perinatal mortality rate of 77.7 per 1000 deliveries. The major maternal complications in the SCD group were anemia (86.2%); sickle cell crisis (64.8% overall, with 43.1% vaso-occlusive, 21.2% hemolytic, and 0.5% sequestration or aplastic); bacterial infection (8.8%); preterm delivery (15.3%); and pre-eclampsia (9.7%). Fetal growth restriction and stillbirths accounted for 65.6% of the perinatal mortality. Blood transfusion was indicated in 33.7% of pregnancies in the SCD group. Conclusion: Pregnant Saudi women with SCD are at increased risk for pregnancy-related complications, as well as fetal morbidity and mortality. A critical need exists among Saudi hospitals for a multidisciplinary approach to the management of pregnancies complicated by SCD. (C) 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.