{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:30:10Z","timestamp":1793115010475,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005265","name":"Division of Blood Disorders and Public Health Genomics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006087","name":"National Center on Birth Defects and Developmental Disabilities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006087","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Whereas pregnancy in sickle cell disease (SCD) is considered high risk, there is limited understanding of pregnancy\u2010 and SCD\u2010related morbidity to inform clinical practice and health policy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>This retrospective cohort study aimed to describe pregnancy\u2010 and disease\u2010related morbidity among individuals with SCD for up to 1\u00a0year postpartum using Medicaid claims (2010\u20132018) linked with newborn screening and clinical reports from four state Sickle Cell Data Collection programs. Medicaid enrollees aged 15\u201344\u00a0years with SCD were included. The most recent delivery hospitalization and associated complications were identified using the International Classification of Diseases nineth and tenth revisions. The main outcomes included pregnancy\u2010 and disease\u2010related complications during pregnancy, at delivery, and up to 1\u00a0year post\u2010delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1286 individuals met the inclusion criteria (43% were 15\u201324\u00a0years old, 50% were 25\u201334\u00a0years old). Most (<jats:italic>n<\/jats:italic> = 957, 74%) were enrolled in Medicaid before pregnancy, 88% (<jats:italic>n<\/jats:italic> = 1132) were enrolled within their first 16\u00a0weeks of pregnancy, and 68% (<jats:italic>n<\/jats:italic> = 876) maintained Medicaid coverage for 1\u00a0year postpartum. High incidence of SCD\u2010related morbidities including vaso\u2010occlusive crisis (37.6%) and acute chest syndrome (5.8%), and obstetric complications\u2014preeclampsia\/eclampsia (9.6%), antepartum hemorrhage (24.2%), and preterm delivery (28.1%)\u2014were reported through 60\u00a0days postpartum. Many individuals continued to have SCD\u2010related complications beyond the 60\u2010day postpartum period, including more than one\u2010third having a vaso\u2010occlusive crisis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Individuals with SCD are at increased risk of pregnancy\u2010 and SCD\u2010related morbidity throughout the perinatal period. Medicaid policies that ensure continuous coverage and encourage comprehensive multidisciplinary care models may reduce both SCD and obstetric complications and promote better maternal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31857","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T23:03:51Z","timestamp":1749769431000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pregnancy\u2010 and Disease\u2010Related Morbidity Among Medicaid Enrollees With Sickle Cell Disease"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4393-4949","authenticated-orcid":false,"given":"Mariam","family":"Kayle","sequence":"first","affiliation":[{"name":"Duke University School of Nursing  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Georgia Health Policy Center Georgia State University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon K.","family":"Attell","sequence":"additional","affiliation":[{"name":"Georgia Health Policy Center Georgia State University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhaqueline","family":"Valle","sequence":"additional","affiliation":[{"name":"Tracking California Public Health Institute  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L.","family":"Reeves","sequence":"additional","affiliation":[{"name":"Susan B Meister Child Health Evaluation and Research Center University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah K.","family":"Peng","sequence":"additional","affiliation":[{"name":"Susan B Meister Child Health Evaluation and Research Center University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Smeltzer","sequence":"additional","affiliation":[{"name":"School of Public Health University of Memphis  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Mukhopadhyay","sequence":"additional","affiliation":[{"name":"School of Public Health University of Memphis  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobi Adeyeye","family":"Amosun","sequence":"additional","affiliation":[{"name":"Tennessee Department of Health  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Sergison","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5149-6355","authenticated-orcid":false,"given":"Angela B.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Georgia Health Policy Center Georgia State University  Atlanta Georgia 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