Maternal and Fetal Outcomes of Pregnant Women With Sickle Cell Disease: A Single‐Center Canadian Study
Wing Man (Joanne) Lam, Natalia Rydz, Nancy Soliman, Dawn Goodyear, Kelsey UminskiABSTRACT
Background
Sickle cell disease (SCD) increases the risk of complications during pregnancy. This study describes antenatal care patterns and maternal and fetal outcomes in pregnant women with SCD in a Canadian setting.
Methods
Women with SCD receiving antenatal/perinatal care through the Southern Alberta Rare Blood and Bleeding Disorders program (January 2010 to January 2025) were identified. Antenatal care, and maternal and fetal outcomes were assessed in periods before (2010–2019) and after (2020–2025) local multidisciplinary protocols for SCD pregnancy management were updated.
Results
21 women (32 pregnancies; 31 neonates) were included. Most pregnancies were followed by maternal‐fetal medicine (81.3%), had regular fetal growth assessments (84.4%), and had high‐dose folic acid (90.6%) and acetylsalicylic acid (56.3%) supplementation; all were implemented more frequently following protocol update. Vaso‐occlusive crises occurred in 56.3% of pregnancies, infections requiring intravenous antibiotics occurred in 21.9%, preeclampsia occurred in 6.3%, and peripartum/postpartum hemorrhages occurred in 28.1%. Transfusions were required in 62.5% of pregnancies. There was one intensive care unit (ICU) admission and no maternal deaths. No neonates had fetal growth restriction and 16.1% required neonatal ICU admission. One stillbirth occurred at 23 weeks (mother had hyperhemolysis).
Conclusions
Multidisciplinary pregnancy management of women with SCD may improve antenatal care and maternal and fetal outcomes.