Sickle Cell Disease and Sickle Cell Trait on Curaçao: Pregnancy‐Related Outcomes and Complications: A Retrospective Cohort Study From a Single Centre

Abstract

ABSTRACTObjectivesTo describe the pregnancy‐related outcomes and complications as well as neonatal outcomes among patients with sickle cell disease (SCD) and sickle cell trat (SCT) on Curaçao over the past half decade.MethodsA retrospective cohort study was conducted. Patients with SCD and SCT were included who gave birth from 1 December 2016 to 9 November 2019 in St. Elisabeth Hospital and from 10 November 2019 to 1 November 2023 in Curaçao Medical Center, Curaçao. Various data regarding participant characteristics, pregnancy‐related outcomes and complications and neonatal data were gathered and analysed. Descriptive statistics were utilized and p values calculated.ResultsThe most common pregnancy‐related complications in patients with SCD were pre‐eclampsia (4; 23.5%), vaso‐occlusive crisis (10; 58.8%), anaemia (15; 88.2%) and urinary tract infection (6; 35.3%). Intrauterine growth restriction was recorded in four (22.2%) pregnancies, five (29.4%) patients delivered preterm and eight (44.4%) neonates had a birth weight below 2500 g. The need for blood transfusion was significantly higher in patients with HbSS compared to patients with HbSC (88.9% HbSS vs. 12.5% HbSC, p = 0.002) and significantly more neonates from patients with HbSS were admitted to the neonatal intensive care unit (66.7% HbSS vs. 11.1% HbSC, p = 0.016). Regarding SCT, anaemia occurred in 78 (25.2%) patients and 73 (23.5%) times the amniotic fluid was stained with meconium.ConclusionThe data of this study support the results of previous studies, displaying a high rate of maternal and neonatal complications and adverse outcomes during pregnancy in patients with SCD. Close observation and a multidisciplinary approach are essential. SCT does not appear to be associated with adverse effects on maternal or foetal outcomes and complications, except for a high rate of meconium‐stained amniotic fluid.