{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T17:16:17Z","timestamp":1771262177425,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate safety of prenatal corticosteroids in pregnancies of women with sickle cell disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter observational study of patients with sickle cell disease, comparing vaso\u2010occlusive crises (VOC) requiring hospital care between pregnancies with versus without prenatal corticosteroids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 40 pregnancies exposed to prenatal corticosteroids, compared with 370 unexposed pregnancies, VOC were not more frequent (62.5% vs 57.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.578) but they were more severe, with more intensive care hospitalizations (25.0% vs 12.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.039), emergency transfusions (44.7% vs 22.7%, <jats:italic>P<\/jats:italic>\u2009=\u20090.006), and acute chest syndromes (22.5% vs 8.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.010). These differences persisted after adjustment for severity and type of sickle cell syndrome (for intensive care admission adjusted odds ratio [aOR] 2.73, 95% confidence interval [CI] 1.10\u20136.79, <jats:italic>P<\/jats:italic>\u2009=\u20090.031 and for acute chest syndrome aOR 4.15, 95% CI 1.57\u201314.4, <jats:italic>P<\/jats:italic>\u2009=\u20090.008). VOC occurred on average 1.2\u2009days following steroid administration. When comparing 36 patients receiving corticosteroids for fetal maturation with 58 patients who were hospitalized for obstetrical complications before 34\u2009weeks of pregnancy but that did not receive corticosteroids, VOC incidence was not significantly higher (41.7% vs 31.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.323).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The present study was the first to study the impact of prenatal corticosteroids on sickle cell disease. They were associated with more severe VOC, suggesting that steroids should be avoided in these women.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14823","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T16:47:02Z","timestamp":1683737222000},"page":"243-255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of prenatal corticosteroid therapy on sickle cell disease in pregnant women"],"prefix":"10.1002","volume":"163","author":[{"given":"Florence","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Assistance Publique\u2010H\u00f4pitaux de Paris H\u00f4pital Louis Mourier, and FHU PREMA  Colombes France"},{"name":"Universit\u00e9 de Paris  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5883-7597","authenticated-orcid":false,"given":"Laurent","family":"Mandelbrot","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Assistance Publique\u2010H\u00f4pitaux de Paris H\u00f4pital Louis Mourier, and FHU PREMA  Colombes France"},{"name":"Universit\u00e9 de Paris  Paris France"},{"name":"Inserm IAME 1137  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Affo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Assistance Publique\u2010H\u00f4pitaux de Paris H\u00f4pital Louis Mourier  Colombes France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2029-8126","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Galacteros","sequence":"additional","affiliation":[{"name":"Red Cell Genetic Disease Unit, Department of Internal Medicine, Assistance Publique\u2010H\u00f4pitaux de Paris GHU Henri Mondor; U\u2010PEC  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Bounan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology H\u00f4pital Delafontaine  Saint Denis France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herv\u00e9","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Assistance Publique\u2010H\u00f4pitaux de Paris H\u00f4pital Bic\u00eatre  Le Kremlin Bic\u00eatre France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Fichez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology H\u00f4pital de la Croix\u2010Rousse  Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6785-7709","authenticated-orcid":false,"given":"Giovanna","family":"Cannas","sequence":"additional","affiliation":[{"name":"Sickle Cell Disease Reference Center H\u00f4pital E. 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