Maternal and Child Health Journal

, Volume 17, Issue 2, pp 200–207

Sickle Cell Disease in Pregnancy: Maternal Complications in a Medicaid-Enrolled Population

  • Sheree L. Boulet
  • Ekwutosi M. Okoroh
  • Ijeoma Azonobi
  • Althea Grant
  • W. Craig Hooper
Article

DOI: 10.1007/s10995-012-1216-3

Cite this article as:
Boulet, S.L., Okoroh, E.M., Azonobi, I. et al. Matern Child Health J (2013) 17: 200. doi:10.1007/s10995-012-1216-3

Abstract

Higher frequencies of pregnancy complications have been reported among women with sickle cell disease (SCD) compared with those without SCD; however, past studies are limited by small sample size, narrow geographic area, and use of hospital discharge data. We compared the prevalence of maternal complications among intrapartum and postpartum women with SCD to those without SCD in a large, geographically diverse sample. Data from the 2004–2010 Truven Health MarketScan® Multi-State Medicaid databases were used to assess the prevalence of maternal complications among intrapartum and postpartum women 15–44 years of age with and without SCD whose race was reported as black. The comparison group of women without SCD was further divided into those with chronic conditions associated with multi-organ failure and those without chronic conditions. Multivariable log-binomial regression models were used to calculate adjusted prevalence ratios for outcomes for women with SCD compared with women in the two comparison groups. Of the 335,348 black women with a delivery during 2004–2010, 1,526 had a diagnosis of SCD (0.5 %). Compared with women without SCD who had chronic conditions, women with SCD had higher prevalence of deep vein thrombosis, pulmonary embolism, obstetric shock, pneumonia, sepsis, postpartum infection, and transfusions. SCD was also positively associated with acute renal failure, cerebrovascular disorder, respiratory distress syndrome, eclampsia, postpartum hemorrhage, preterm birth, and ventilation when compared with women without SCD and chronic conditions. Overall, women with SCD have increased prevalence of pregnancy complications, even when compared with a group of women with similar risk for multi-organ failure.

Keywords

Sickle cell disease Sickle cell anemia Pregnancy Pregnancy complications 

Copyright information

© Springer Science+Business Media New York (outside the USA)  2013

Authors and Affiliations

  • Sheree L. Boulet
    • 1
  • Ekwutosi M. Okoroh
    • 2
  • Ijeoma Azonobi
    • 2
  • Althea Grant
    • 2
  • W. Craig Hooper
    • 2
  1. 1.Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGeorgia
  2. 2.National Center on Birth Defects and Developmental DisabilitiesCenters for Disease Control and PreventionAtlantaGeorgia

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