(Press-News.org) (WASHINGTON - March 23, 2015) - New research reports that when compared to healthy pregnant women, pregnant women with a severe form of sickle cell disease (SCD) are six times more likely to die during or following pregnancy and have an increased risk for stillbirth, high blood pressure, and preterm delivery. Research findings, published online today in Blood, the Journal of the American Society of Hematology (ASH), are the first to estimate several health risks facing pregnant women with SCD and identify those who are at highest risk of complications.
People with SCD produce abnormal hemoglobin, a protein that helps carry oxygen throughout the body. This defect causes the red blood cells to become rigid and sickle-shaped, blocking the flow of blood and oxygen to the body and causing intense pain and other complications such as infections. Previous research has identified an association between SCD and high-risk pregnancy; however, specialists have not yet been able to estimate a woman's individual risk for specific complications, nor have they been able to identify groups of women at highest risk.
"While we know that women with sickle cell disease will have high-risk pregnancies, we have lacked the evidence that would allow us to confidently tell these patients how likely they are to experience one complication over another," said senior study author Eugene Oteng-Ntim, MD, of the Guy's and St. Thomas' NHS Foundation Trust and Honorary Senior Lecturer at King's College London. "This reality makes it difficult for us as care providers to properly counsel our sickle cell patients considering pregnancy."
To better estimate pregnancy-related complications in women with SCD, Dr. Oteng-Ntim and a team of researchers from King's College London and the London School of Hygiene & Tropical Medicine examined 21 published observational studies comparing outcomes in women with and without SCD. As a whole, the studies included 26,349 pregnant women with SCD and 26,151,746 pregnant women who shared attributes with the SCD population, such as ethnicity or location, but were otherwise healthy. Investigators classified the SCD population based on genotype, or form of disease, including 1,276 women with the classic form (HbSS genotype), 279 with a milder form (HbSC genotype), and 24,794 whose disease genotype was unreported. Thirteen of the studies originated from high-income countries ($30,000 income per capita or greater), and the remaining were from low- to median-income countries.
Based on their analysis, researchers concluded that pregnant women with classic SCD living in a low-income country were at the highest risk for complications. When researchers compared these women to healthy pregnant women, they observed that women with the most severe form of SCD in both high- and low-income countries were six times more likely to die during or shortly after pregnancy. Researchers also noted that women with severe SCD had an increased risk of high blood pressure during pregnancy (known as pre-eclampsia), stillbirth, preterm delivery, and delivering smaller-than-average infants.
While the analysis states that pregnant women with a milder or an unreported form of SCD were less likely than those with severe disease to experience complications, researchers note that these women remain at higher risk of most complications than healthy mothers. Researchers also concluded that women with SCD living in developed countries were less likely to experience death and stillbirth than those in lower-income areas. In addition, pre-eclampsia, preterm delivery, and delivery of smaller-than-average infants were not significantly different between high- and low-income countries, suggesting that risk of these conditions depends on access to care.
"Our report suggests that, even in developed countries with advanced care, there continues to be a much higher maternal mortality rate in women with sickle cell disease compared to the general population, strongly suggesting that more work must be done to improve outcomes for these patients and their families," said Dr. Oteng-Ntim. "By improving care providers' ability to more accurately predict adverse outcomes, this analysis is a first step toward improving universal care for all who suffer from this disease."
INFORMATION:
Blood , the most cited peer-reviewed publication in the field of hematology, is available weekly in print and online. Blood is the official journal of the American Society of Hematology (ASH), the world's largest professional society concerned with the causes and treatment of blood disorders.
ASH's mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems by promoting research, clinical care, education, training, and advocacy in hematology.
Blood® is a registered trademark of the American Society of Hematology.
ANN ARBOR, Mich. -- Despite reports indicating job dissatisfaction among some physicians, at least one group of doctors seems to be starting their careers on the right note - pediatricians.
The majority of new general pediatricians say the most important factor in their top choice for their first job was lifestyle, spouses or family - and more than two- thirds believe their current jobs are consistent with their career goals, a new University of Michigan study says.
The findings, which appear today in Pediatrics, come just as medical students around the country learned ...
Tumors that produce more stress granules are more likely to metastasize, according to a study published in The Journal of Cell Biology. The results suggest that drugs to inhibit the formation of these structures might rein in cancer metastasis.
When cells are under duress, they curtail almost all protein synthesis and stash their mRNAs in stress granules. These structures help healthy cells, but they also allow tumor cells to survive harsh conditions. A protein named YB-1, which is overexpressed in many types of tumors, accumulates in stress granules, but researchers ...
WASHINGTON - When it comes to adolescents with math and science homework, more isn't necessarily better -- an hour a day is optimal -- but doing it alone and regularly produces the biggest knowledge gain, according to research published by the American Psychological Association.
Researchers from the University of Oviedo in Spain looked at the performance of 7,725 public, state-subsidized and private school students in the principality of Asturias in northern Spain. The students had a mean age of 13.78. Girls made up 47.2 percent of the sample. The article was published ...
Research by biologists at the University of York has identified new mechanisms potentially driving progression of an aggressive form of dementia.
The research, which was funded by Alzheimer's Society and the Biotechnology and Biological Sciences Research Council (BBSRC), is published today in The Journal of Cell Biology.
Working with scientists at the University of Massachusetts Medical School and University of Puerto Rico, the researchers studied how synapses - the connections between neurons - are affected by changes in the protein CHMP2B that are linked to Frontotemporal ...
LOS ANGELES (March 23, 2015) - Men who exercise more have better erectile and sexual function, regardless of race, according to a recent study published in the Journal of Sexual Medicine.
While past studies have highlighted the relationship between better erectile function and exercise, African-American men have been underrepresented in this literature.
"This study is the first to link the benefits of exercise in relation to improved erectile and sexual function in a racially diverse group of patients," said Adriana Vidal, PhD, senior author of the study and investigator ...
DENVER, March 23, 2015 -- Saccharin, the artificial sweetener that is the main ingredient in Sweet 'N Low®, Sweet Twin® and Necta®, could do far more than just keep our waistlines trim. According to new research, this popular sugar substitute could potentially lead to the development of drugs capable of combating aggressive, difficult-to-treat cancers with fewer side effects.
The finding will be presented today at the 249th National Meeting & Exposition of the American Chemical Society (ACS), the world's largest scientific society. The meeting features nearly ...
DENVER, March 23, 2015 -- Squid are the ultimate camouflage artists, blending almost flawlessly with their backgrounds so that unsuspecting prey can't detect them. Using a protein that's key to this process, scientists have designed "invisibility stickers" that could one day help soldiers disguise themselves, even when sought by enemies with tough-to-fool infrared cameras.
The researchers will present their work today at the 249th National Meeting & Exposition of the American Chemical Society (ACS). ACS, the world's largest scientific society, is holding the meeting ...
DENVER, March 23, 2015 -- More than a year into Colorado's experiment legalizing marijuana, labs testing the plants are able for the first time to take stock of the drug's potency and contaminants -- and openly paint a picture of what's in today's weed. At the 249th National Meeting & Exposition of the American Chemical Society (ACS), one such lab will present trends -- and some surprises -- that its preliminary testing has revealed about the marijuana now on the market.
ACS, the world's largest scientific society, is holding the meeting here through Thursday. It features ...
Researchers from the University of Copenhagen are the first in the world to develop a secure way of measuring the important protein apo-M. This could prove relevant for research into diseases such as diabetes, arteriosclerosis and sclerosis.
For the first time, researchers from the University of Copenhagen have managed to develop a secure way of measuring the protein apo-M in our blood. The protein is interesting because it may prove important to research into diseases such as multiple sclerosis, arteriosclerosis and diabetes.
'We know that apo-M is of importance to ...
States that have expanded their Medicaid programs under the Affordable Care Act (ACA) are capturing an increased number of people with previously undiagnosed diabetes, allowing them to begin treatment earlier, potentially reducing complications and other negative outcomes, according to a study being published online today and in the May issue of Diabetes Care.
The release of the study coincides with the 5th anniversary of the ACA, which expanded Medicaid eligibility to reach nearly all non-elderly adults with incomes at or below 138 percent of the federal poverty level ...
