Effects of Sickle Trait on Incidence and Outcomes of Hypertensive Disorders of Pregnancy [13L

Abstract

INTRODUCTION: Due to a paucity of research and conflicting results in the few published studies, effects of sickle cell trait (SCT) on the incidence & severity of hypertensive disorders in pregnancy and potential adverse perinatal outcomes remain inconclusive. The objective of this research was to examine the risk of hypertensive disorders in pregnancy among SCT carriers compared to non SCT carriers in a single institution, in Flint, Michigan. METHODS: This is an IRB-approved, retrospective cohort study. Pregnant women admitted to Labor and Delivery at Hurley Medical Center over a 5-year period (between 06/01/2012 to 06/01/2017) were included if SCT status (presence or absence) was confirmed through laboratory analysis. RESULTS: The study included 3,986 patients. 279 patients were carriers of SCT (7%). Maternal age ranged from 13-46 years (mean=25.00, SD 5.12). The majority of our subjects were African American (76.4%, n=3044). 1047 patients were nulliparous (26.4%). Incidence of preeclampsia was higher among patients with SCT (3.9%, n=11) compared to noncarriers [(2.0%, n=75, P=.033, relative risk 1.9487 (95% CI 1.0472–3.6262)]. There was no statistical difference in the incidence of other hypertensive diagnoses among the two groups. There was no statistically significant difference in preterm delivery by SCT status (P=.311). CONCLUSION: In our study population, there was a higher incidence of preeclampsia in patients with SCT. However, we were not able to determine if SCT correlated with increased incidence of preeclampsia with severe features or eclampsia. Larger, multi-institutional studies would be required to determine if the SCT may impact severity of hypertensive complications in carriers.