{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T03:22:55Z","timestamp":1772076175484,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>We aimed to identify risk factors for adverse outcomes in pregnancies of women with sickle cell disease (SCD) and develop risk prediction models. Models were derived from a retrospective cohort of pregnant women with SCD and constructed using generalised estimating equation\u00a0logistic regression, with clustering by woman. Maternal event(s) consisted of acute anaemia; cardiac, pulmonary, hepatobiliary, musculoskeletal, skin, splenic, neurological or renal complications, multi\u2010organ failure, venous thromboembolism, admission\u2010requiring vaso\u2010occlusive events (VOE), red cell transfusion, mortality or hypertensive disorder of pregnancy. Fetal events included preterm birth, small\u2010for\u2010gestational\u2010age or perinatal mortality. Of 199 pregnancies, 71% and 45% resulted in adverse maternal and fetal outcomes respectively. Low first\u2010trimester haemoglobin, admission\u2010requiring VOE in the year before pregnancy, multiple transfusions before pregnancy, SCD genotype and previous cardiac complications predicted maternal risk. Younger age and SCD genotype allowed early prediction of fetal risk (model\u2010F1). Adding maternal event(s) and high lactate dehydrogenase enabled re\u2010assessment of fetal risk with advancing gestation (model\u2010F2). Models were well calibrated and moderately discriminative for maternal outcome (c\u2010statistic 0\u00b781, cross\u2010validated value 0\u00b779) and fetal outcome (model\u2010F1 c\u2010statistic 0\u00b768, cross\u2010validated value 0\u00b765; model\u2010F2 c\u2010statistic 0\u00b772, cross\u2010validated value 0\u00b768). The models will allow early identification of women with SCD at high risk of adverse events, permitting early targeted interventions and ongoing fetal risk re\u2010assessment enabling intensification of surveillance and optimisation of delivery timing.<\/jats:p>","DOI":"10.1111\/bjh.17607","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T10:05:46Z","timestamp":1623665146000},"page":"1063-1073","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Distinct maternal and fetal pregnancy outcomes in women with sickle cell disease can be predicted using routine clinical and laboratory data"],"prefix":"10.1111","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3466-7570","authenticated-orcid":false,"given":"A. Kinga","family":"Malinowski","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Division of Maternal\u2010Fetal Medicine Mount Sinai Hospital Toronto ON Canada"},{"name":"Lunenfeld\u2010Tanenbaum Research Institute Mount Sinai Hospital Toronto ON Canada"},{"name":"Faculty of Medicine University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-9238","authenticated-orcid":false,"given":"Kevin H. M.","family":"Kuo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto Toronto ON Canada"},{"name":"Division of Medical Oncology and Haematology Department of Medicine University Health Network Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George A.","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto Toronto ON Canada"},{"name":"Department of Medicine University Health Network Toronto ON Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Palcu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Ward","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto Toronto ON Canada"},{"name":"Division of Medical Oncology and Haematology Department of Medicine University Health Network Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-6256","authenticated-orcid":false,"given":"Nadine","family":"Shehata","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto Toronto ON Canada"},{"name":"Division of Medical Oncology and Haematology Department of Medicine University Health Network Toronto ON Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto ON Canada"},{"name":"Department of Medicine Division of Haematology Mount Sinai Hospital Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406093302303"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2011.07.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2005.07.003"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.07.008"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13786"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-11-607317"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12626"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.016"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6818e1"},{"key":"e_1_2_8_12_1","first-page":"1","volume-title":"Saving lives, improving mothers\u2019 care \u2010 lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2016\u20102018","author":"Knight M","year":"2020"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-06-649319"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14767"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2013.1.439"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199107043250103"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21550"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X0102100106"},{"key":"e_1_2_8_20_1","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2019"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13270"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12447"},{"key":"e_1_2_8_23_1","first-page":"CD010378","article-title":"Prophylactic versus selective blood transfusion for sickle cell disease in pregnancy","volume":"12","author":"Okusanya BO","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(94)70393-0"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjhh.2014.07.002"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14112"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.14302\/issn.2381-862X.jwrh-14-625"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2006.07.001"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/10245332.2016.1187843"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056541"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.12.020"},{"key":"e_1_2_8_32_1","first-page":"1053","article-title":"Young maternal age and adverse neonatal outcome","volume":"141","author":"McAnarney ER","year":"1987","journal-title":"Am J Dis Child"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc13895"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/sper.2002.29838"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.14423\/SMJ.0000000000000900"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.75807"},{"key":"e_1_2_8_37_1","unstructured":"US Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER) Center for Biologics Evaluation and Research (CBER).Postapproval pregnancy safety studies: guidance for industry (draft guidance).Silver Spring MD:Food and Drug Administration;2019. p.1\u201327. Available from:https:\/\/www.fda.gov\/media\/124746\/download. [cited 2019 September 5]."},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.2.e35"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.17607","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bjh.17607","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.17607","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T11:13:52Z","timestamp":1692702832000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.17607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,14]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/bjh.17607"],"URL":"https:\/\/doi.org\/10.1111\/bjh.17607","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,14]]},"assertion":[{"value":"2021-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}