{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:51:19Z","timestamp":1790895079019,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T00:00:00Z","timestamp":1496966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["Grant 2 UL1 TR000445\u201006"],"award-info":[{"award-number":["Grant 2 UL1 TR000445\u201006"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low\u2010resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low\u2010resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before\u2010and\u2010after study, at the Korle\u2010Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric\u2010hematology care team for women with SCD in a combined SCD\u2010Obstetric Clinic. The pre\u2010intervention period was assessed through a retrospective chart review to identify every death and the post\u2010intervention period was assessed prospectively. Interventions consisted of joint obstetrician and hematologist outpatient and acute inpatient reviews, close maternal and fetal surveillance, and simple protocols for management of acute chest syndrome and acute pain episodes. Primary outcomes included maternal and perinatal mortality rates before and after the study period. A total of 158 and 90 pregnant women with SCD were evaluated in the pre\u2010 and post\u2010 intervention periods, respectively. The maternal mortality rate decreased from 10\u00a0791 per 100\u00a0000 live births at pre\u2010intervention to 1176 per 100\u00a0000 at post\u2010intervention, representing a risk reduction of 89.1% (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.007). Perinatal mortality decreased from 60.8 per 1000 total births at pre\u2010intervention to 23.0 per 1000 at post\u2010intervention, representing a risk reduction of 62.2% (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.20). A multidisciplinary obstetric and hematology team approach can dramatically reduce maternal and perinatal mortality in a low\u2010resource setting.\n                  <\/jats:p>","DOI":"10.1002\/ajh.24790","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T21:47:11Z","timestamp":1494971231000},"page":"872-878","source":"Crossref","is-referenced-by-count":43,"title":["Implementation of multidisciplinary care reduces maternal mortality in women with sickle cell disease living in low\u2010resource setting"],"prefix":"10.1002","volume":"92","author":[{"given":"Eugenia Vicky","family":"Asare","sequence":"first","affiliation":[{"name":"Ghana Institute of Clinical Genetics Korle\u2010Bu Accra Ghana"},{"name":"Department of Hematology, College of Health Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1646-4470","authenticated-orcid":false,"given":"Edeghonghon","family":"Olayemi","sequence":"additional","affiliation":[{"name":"Ghana Institute of Clinical Genetics Korle\u2010Bu Accra Ghana"},{"name":"Department of Hematology, College of Health Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Boafor","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Korle\u2010Bu Teaching Hospital Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Dei\u2010Adomakoh","sequence":"additional","affiliation":[{"name":"Department of Hematology, College of Health Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enoch","family":"Mensah","sequence":"additional","affiliation":[{"name":"Department of Hematology, College of Health Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Ghansah","sequence":"additional","affiliation":[{"name":"Department of Hematology, College of Health Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Osei\u2010Bonsu","sequence":"additional","affiliation":[{"name":"Ghana Institute of Clinical Genetics Korle\u2010Bu Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selina","family":"Crabbe","sequence":"additional","affiliation":[{"name":"Ghana Institute of Clinical Genetics Korle\u2010Bu Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latif","family":"Musah","sequence":"additional","affiliation":[{"name":"Department of Physiology, School of Biomedical and Allied Health Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Hayfron\u2010Benjamin","sequence":"additional","affiliation":[{"name":"Department of Physiology, School of Biomedical and Allied Health Sciences University of Ghana Accra Ghana"},{"name":"Department of Anesthesia Korle\u2010Bu Teaching Hospital Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Covert","sequence":"additional","affiliation":[{"name":"Vanderbilt\u2010Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adetola A.","family":"Kassim","sequence":"additional","affiliation":[{"name":"Vanderbilt\u2010Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andra","family":"James","sequence":"additional","affiliation":[{"name":"Duke University Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Rodeghier","sequence":"additional","affiliation":[{"name":"Statistical Consultant Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0574-1604","authenticated-orcid":false,"given":"Michael R.","family":"DeBaun","sequence":"additional","affiliation":[{"name":"Vanderbilt\u2010Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel A.","family":"Oppong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Korle\u2010Bu Teaching Hospital Accra Ghana"},{"name":"Department of Obstetrics and Gynecology, School of Medicine and Dentistry University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"OrganizationWH.Management of Haemoglobin Disorders. Report of a Joint WHO\u2010TIF Meeting. Nicosia Cyprus;2007."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24235"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25608"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13270"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(92)90376-T"},{"key":"e_1_2_8_7_1","first-page":"19","article-title":"Pregnancy outcome in HbSS\u2010sickle cell disease in Lagos, Nigeria","volume":"21","author":"Odum CU","year":"2002","journal-title":"West Afr J Med."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2012.11-0625"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056541"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13786"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199509143331104"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_8_13_1","first-page":"56","article-title":"Sickle cell disease among children in Africa: An integrative literature review and global recommendations","volume":"3","author":"Lucky L","year":"2015","journal-title":"Int J Afr Nurs Sci."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-09-702324"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.8.3.177"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V96.5.1685"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-06-649319"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2010.05.022"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00367-3"},{"key":"e_1_2_8_20_1","volume-title":"Annual Morbidity and Mortality Report 2014","author":"Gynaecology DoOa","year":"2014"},{"key":"e_1_2_8_21_1","unstructured":"WHO U UNFPA World Bank Group and the United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015.2015. pp 1\u201377."},{"key":"e_1_2_8_22_1","first-page":"1","article-title":"Fetal and perinatal mortality: United States, 2013","volume":"64","author":"MacDorman MF","year":"2015","journal-title":"Natl Vital Stat Rep."}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.24790","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.24790","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T13:08:10Z","timestamp":1695560890000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.24790"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,9]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1002\/ajh.24790"],"URL":"https:\/\/doi.org\/10.1002\/ajh.24790","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,9]]}}}