Takeaway
- Pregnant women with sickle cell disease (SCD) are at an increased risk of pulmonary complications, including acute chest syndrome (ACS)/pneumonia.
- In addition, pulmonary complications contribute significantly to maternal mortality in women with SCD.
- Findings can be used to aid preconceptual counselling and for optimal management of SCD during pregnancy by highlighting the need for timely identification of pulmonary complications.
Study design
- Meta-analysis of 22 studies included 3964 pregnancies with SCD and 336,559 pregnancies without SCD after a search across electronic databases.
- Funding: None disclosed.
- The estimated prevalence of pulmonary thromboembolism (PTE) was 105/10000 (95% CI, 65-170) in pregnant women with SCD and 13.8/10000 (95% CI, 12.5-15.1) in women without SCD in pregnancy.
- Pregnant women with SCD vs those without SCD were at an almost 8-fold increased risk of PTE (risk ratio [RR], 7.74; 95% CI, 4.65-12.89).
- The prevalence of ACS/pneumonia was 6.46% (95% CI, 4.66-8.25%) in women with SCD during pregnancy.
- No significant difference was observed in the prevalence of ACS/pneumonia between the HbSS and HbSC genotypes (RR, 1.42; 95% CI, 0.90-2.23).
- Overall 88% of the maternal deaths reported were secondary to pulmonary complications (6 studies).
- Small number of women contributed >1 pregnancy to an individual study.
- Risk of confounding.
- Heterogeneity between studies.
References
References
