{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T14:25:57Z","timestamp":1785594357787,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To document pregnancy outcome in homozygous sickle cell (SS) disease and in age\u2010matched controls with a normal haemoglobin genotype followed from birth for up to 45\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 100\u00a0000 consecutive non\u2010operative deliveries screened for sickle cell disease at the main Government maternity hospital in Kingston, Jamaica between 1973 and 1981 detected 311 (149 female) babies with SS disease who were matched by age and gender with 250 (129 female) controls with an AA haemoglobin phenotype. These individuals have been followed from birth with prospective assessment of menarche and detailed documentation of all pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 177 pregnancies in 71 SS patients and 226 pregnancies in 74 AA controls. Mothers with SS disease had more spontaneous abortions (adjusted relative risk [aRR] 3.2, 95% CI 1.6\u20136.1), fewer live births (aRR 0.7, 95% CI 0.6\u20130.9) and their offspring were more likely to have a gestational age &lt;37\u00a0weeks (aRR 2.1, 95% CI 1.1\u20133.7) and low birthweight &lt;2.5\u00a0kg (aRR 3.0, 95% CI 1.6\u20135.3). They were more prone to acute chest syndrome (aRR 13.7, 95% CI 4.1\u201345.5), urinary tract infection (aRR 12.8, 95% CI 1.3\u2013125.9), pre\u2010eclampsia\/eclampsia (aRR 3.1, 95% CI 1.1\u20138.8), retained placenta (aRR 10.1, 95% CI 1.1\u201390.3), sepsis (Fisher's Exact test 0.04) and pregnancy\u2010related deaths (Fisher's Exact test 0.02). Four of five deaths were attributable to acute chest syndrome. There was no genotypic difference in pregnancy\u2010induced hypertension or postpartum haemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pregnancy in SS disease carries risks for both mother and child. The variable characteristics of pregnancy\u2010related deaths complicate their prevention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Pregnancy in SS disease compared with controls showed increased abortions and stillbirths, fewer live births and maternal deaths in 7% patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16696","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T14:29:00Z","timestamp":1615213740000},"page":"1703-1710","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pregnancy outcome in homozygous sickle cell disease: observations from the Jamaican Birth Cohort"],"prefix":"10.1111","volume":"128","author":[{"given":"G","family":"Lewis","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Health University of the West Indies Kingston Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Thame","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Health University of the West Indies Kingston Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Howitt","sequence":"additional","affiliation":[{"name":"Sir George Alleyne Chronic Disease Research Centre The University of the West Indies, Cave Hill Bridgetown Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Hambleton","sequence":"additional","affiliation":[{"name":"Sir George Alleyne Chronic Disease Research Centre The University of the West Indies, Cave Hill Bridgetown Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4684-0286","authenticated-orcid":false,"given":"GR","family":"Serjeant","sequence":"additional","affiliation":[{"name":"The Sickle Cell Trust Kingston Jamaica"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(41)90869-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(71)90772-1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(73)90208-1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24790"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.85.5.375"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000127433.23611.54"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1986.tb04117.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/20.6.666"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1981.tb02750.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1982.tb03915.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198206173062402"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001133420203"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199509143331104"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(80)90241-0"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13786"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-11-607317"},{"key":"e_1_2_7_18_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":"W Afr J Med"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2012.11-0625"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-2768"},{"key":"e_1_2_7_21_1","first-page":"123","article-title":"Placental histology and placental\/fetal weight ratios in pregnant women with sickle cell disease: relationship to pregnancy outcome","volume":"5","author":"Anyaegbunam A","year":"1994","journal-title":"J Assoc Acad Minor Phys"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1994.02170110042007"},{"key":"e_1_2_7_23_1","first-page":"577","article-title":"Third\u2010trimester prediction of small\u2010for\u2010gestational\u2010age infants in pregnant women with sickle cell disease. 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