Lower rates of maternal morbidities among pregnant women suffering from sickle cell disease who are exposed to hydroxyurea, a retrospective study from tribal area of Western India.

Background: Sickle cell disease (SCD) is a common inherited blood disorder causing high maternal and fetal morbidity during pregnancy. Hydroxyurea (HU) is a standard SCD therapy, but its safety in pregnancy remains uncertain due to concerns about congenital anomalies. This study evaluates maternal-fetal outcomes in pregnant women with SCD who received HU versus those who did not.

Research design and methods: A retrospective review was conducted at Kasturba Hospital, Gujarat, India. Pregnant women with SCD who received HU were compared with a historic control group. Maternal morbidities, fetal outcomes, and congenital anomalies were assessed. Poisson regression was done.

Results: Among a total of 235 pregnant women with SCD, 154 received HU (440.5 person-months), while 81 did not (269.6 person-months). The HU group had a lower adverse maternal event score (91.2 vs. 109.8 per 100 person-months, adjusted IRR 0.82, 95% CI 0.71-0.96, p = 0.01) and reduced maternal morbidity, blood transfusion needs, complications, and deaths. No significant increase in congenital anomalies was observed. Fetal-outcomes, including live-birth, stillbirth, low birth weight, and prematurity, were comparable between groups, with no statistically significant differences.

Conclusions: HU use in pregnancy lowered maternal morbidity without increasing congenital anomalies. Further prospective studies are needed in resource-limited settings.