Abstract Number: PB2530
Meeting: ISTH 2020 Congress
Background: Pregnancy in women with sickle cell disease has an increased risk of complications for both mother and infant. While sickle cell mothers have an increase in painful episodes, infection, pulmonary complications and thromboembolic events, there is also a higher risk of stillbirth and low birth weight for the fetus/neonate. Increased vaso-occlusion, viscosity and hypercoagulability in both the mother and the placenta are thought to explain the increased incidence of placental infarction and necrosis that lead to these higher rates of adverse perinatal and fetal outcomes. Higher hemoglobin F (HbF) levels correlate generally with a better prognosis in sickle cell disease patients but it is unclear whether the protective effect of a higher affinity hemoglobin holds true for the uteroplacental circulation.
Aims: We hypothesized that HbF levels might have an effect on pregnancy outcomes such as spontaneous abortions, pre-eclampsia, or low birth weight.
Methods: We reviewed the obstetrical history of a cohort of 61 female sickle cell patients. Demographics, age of mother at delivery, past medical history of mother (crises, medications, transfusions, avascular necrosis), number of spontaneous abortions, adverse perinatal outcomes, gestational age at delivery, birth weight, and complications.
Results: Patient HbF levels did not correlate with number of spontaneous abortions
(r = 0.083, p-value = 0.52) and there were no pairwise differences in HbF levels in patients who had a history of spontaneous abortions versus those without (p = 1.0). We also found that there was no difference in HbF levels between mothers who had experienced pre-eclampsia and those who did not (p = 0.89) and no significant correlation with birth weight of first child (r = 0.26, p = 0.33).
Conclusions: We could not find a mitigating effect of HbF on pregnancy, perinatal adverse outcomes or childbirth in women with sickle cell disease.
INSIGHTS Study Clinical Trial NCT02156102
NIH Project Number: ZIA-HG200394-06
To cite this abstract in AMA style:Kenworthy C, Crouch A, Bonham V, Minniti C, Billett HH. Lack of Disease Modification of HbF on Pregnant Women with Sickle Cell Disease [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/lack-of-disease-modification-of-hbf-on-pregnant-women-with-sickle-cell-disease/. Accessed December 6, 2023.
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