Effects of sickle trait on maternal and perinatal outcomes among pregnant women

Abstract

The risk of multiple adverse pregnancy outcomes and perinatal outcomes among pregnant women with sickle cell trait (SCT) is not known. Our objective was to compare differences in adverse outcomes, specifically pregnancy-related hypertensive disease (PRHD), pyelonephritis/urinary tract infection (UTI), and low birth weight (LBW), between pregnant women with SCT and healthy controls. This was a retrospective cohort study of women who delivered between 2015 and 2020. We included all women with SCT, that is, hemoglobin electrophoresis AS. Women with SCT were matched in a 1:2 to women without SCT, controlling for age, gravidity, and parity. Our primary outcomes were PRHD, pyelonephritis/UTI, and LBW baby. Multivariable logistic regression modeling examined the associations between patients’ characteristics and the primary outcomes.There were 162 women with SCT, and 324 healthy control women were enrolled. Bivariate analysis revealed that women with SCT had a higher proportion of PRHD (38.9% vs 34.9%; P = .39), pyelonephritis/UTI (11.7% vs 7.1%; P = .09), but a lower proportion of LBW (10.5% vs 16.0%; P = .1). In multivariable analysis, after controlling for confounders, SCT was not an independent predictor of PRHD. However, SCT was an independent predictor of pyelonephritis/UTI (adjusted odds ratio [aOR], 1.98; 95% confidence interval [CI], 1.02-3.85) and of a lower risk of having a LBW baby (aOR, 0.48; 95% CI, 0.25-0.94). SCT is not associated with an increased risk of PRHD. However, SCT is associated with pregnancy outcomes, including higher risk of pyelonephritis/UTI but a lower risk of LBW babies.