{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:42:42Z","timestamp":1789681362573,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"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":[[2025,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Pregnant individuals with sickle cell disease (SCD) are more likely to have postpartum complications. In this retrospective single\u2010centre study, 201 pregnancies from 145 individuals were assessed between 2000 and 2018 for the presence of a composite of immediate postpartum complications from admission during delivery to discharge, which included vaso\u2010occlusive pain events, acute chest syndrome, infection (blood, urine, pulmonary) and\/or new\u2010onset hypoxia. Hypoxia was defined as SpO\n                    <jats:sub>2<\/jats:sub>\n                    below 92%. An immediate postpartum complication occurred in 74 pregnancies (37%), of which 97% experienced a vaso\u2010occlusive pain event. No immediate postpartum deaths were recorded. Pregnancies with HbSS\/HbS\u03b20 as compared to HbSC\/HbS\u03b2+ had a higher incidence of the composite outcome (51% vs. 19%). On univariate analysis, HbSS\/HbS\u03b20 genotype was associated with a higher likelihood of developing a postpartum complication (OR 4.49, 95%CI 2.35\u20138.57;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001); however, this significance was reduced on multivariable analysis. The strongest risk factors associated with experiencing the composite outcome on multivariable analysis were hypoxia during pregnancy (OR 4.95, 95%CI 1.86\u201313.23;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001) and an unscheduled caesarean delivery (OR 2.67; 95%CI 1.26\u20135.64;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01). Future studies need to address whether correcting hypoxia and use of predictive scores to guide the need for a scheduled caesarean delivery can reduce immediate postpartum complication rates.\n                  <\/jats:p>","DOI":"10.1111\/bjh.20178","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T02:19:00Z","timestamp":1749003540000},"page":"225-234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk factors for immediate postpartum sickle cell disease\u2010specific maternal morbidity"],"prefix":"10.1111","volume":"207","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9253-6635","authenticated-orcid":false,"given":"Joanna","family":"Loh","sequence":"first","affiliation":[{"name":"Division of Medical Oncology and Hematology, Department of Medicine University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-9238","authenticated-orcid":false,"given":"Kevin H. M.","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology, Department of Medicine University Health Network  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto  Toronto Ontario Canada"},{"name":"Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Department of Medicine University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilinca","family":"Georgescu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Division of Medicine Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Huszti","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto  Toronto Ontario Canada"},{"name":"Department of Biostatistics University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Shehata","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto  Toronto Ontario Canada"},{"name":"Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Department of Medicine University Health Network  Toronto Ontario Canada"},{"name":"Department of Hematology, Division of Medicine Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Kinga","family":"Malinowski","sequence":"additional","affiliation":[{"name":"Department of Hematology, Division of Medicine Mount Sinai Hospital  Toronto Ontario Canada"},{"name":"Department of Obstetrics and Gynaecology, Division of Maternal\u2010Fetal Medicine Mount Sinai Hospital  Toronto Ontario Canada"},{"name":"Lunenfeld\u2010Tanenbaum Research Institute, Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2011.07.005"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1671333"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26818"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.54552"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-11-607317"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-012-1216-3"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18160"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023011301"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13270"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17983"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2015.68.5.469"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03017204"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2021-151914"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V86.10.3676.bloodjournal86103676"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-04-383430"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2023.1580"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/DBP.0000000000000469"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199107043250103"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17607"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/401323"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25097"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-03-818195"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.06.035"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020005934"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-05-221333"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17671"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61726-7"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14575"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.20178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:19:23Z","timestamp":1765534763000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.20178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/bjh.20178"],"URL":"https:\/\/doi.org\/10.1111\/bjh.20178","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,3]]},"assertion":[{"value":"2025-01-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}