{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:31:03Z","timestamp":1769502663339,"version":"3.49.0"},"reference-count":59,"publisher":"American Society of Hematology","issue":"10","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,5,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The health effects of sickle cell trait among children are unknown. We compared select health outcomes and health services utilization among children with sickle cell trait, sickle cell anemia (SCA), and normal hemoglobin. Newborn screening records were used to identify children with sickle cell trait and SCA born in Michigan (1997-2014) who were enrolled in Michigan Medicaid for \u22651 year from 2012 to 2014. Each select health outcome (acute otitis media, acute respiratory infections, fever, invasive pneumococcal disease, pneumonia and influenza, renal complications, spleen problems, stroke) was defined as \u22651 claim with a diagnosis code for the respective outcome within a study year. Health services utilization was summarized as counts of emergency department, inpatient, and outpatient encounters. The relationship between hemoglobin status and each health outcome or utilization was assessed by logistic or negative binomial regression with generalized estimating equations. The study population consisted of 18\u2009257 children with sickle cell trait, 368 with SCA, and 74\u2009523 with normal hemoglobin (227\u2009188 total person-years). Compared with those with normal hemoglobin, children with sickle cell trait had lower odds of acute otitis media (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.84-0.91), acute respiratory infections (OR, 0.94; 95% CI, 0.92-0.97), pneumonia and influenza (OR, 0.93; 95% CI, 0.87-0.99), and outpatient visits (incidence rate ratio, 0.95; 95% CI, 0.93-0.97). Children with SCA had higher or nonsignificant odds of all outcomes and types of health services utilization. These results indicate that children with sickle cell trait may not be at additional health risk for these outcomes. However, additional case-control studies may be necessary to identify rare events.<\/jats:p>","DOI":"10.1182\/bloodadvances.2018028043","type":"journal-article","created":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T20:55:23Z","timestamp":1558126523000},"page":"1574-1580","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":20,"title":["Health outcomes and services in children with sickle cell trait, sickle cell anemia, and normal hemoglobin"],"prefix":"10.1182","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9145-0183","authenticated-orcid":false,"given":"Sarah L.","family":"Reeves","sequence":"first","affiliation":[{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, and"},{"name":"Department of Epidemiology, University of Michigan, Ann Arbor, MI; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah K.","family":"Jary","sequence":"additional","affiliation":[{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer P.","family":"Gondhi","sequence":"additional","affiliation":[{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Kleyn","sequence":"additional","affiliation":[{"name":"Michigan Department of Health and Human Services, Lansing, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Dombkowski","sequence":"additional","affiliation":[{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"234","published-online":{"date-parts":[[2019,5,17]]},"reference":[{"issue":"4 suppl","key":"2020021108292336100_B1","doi-asserted-by":"crossref","first-page":"S512","DOI":"10.1016\/j.amepre.2009.12.022","article-title":"Population estimates of sickle cell disease in the U.S","volume":"38","author":"Hassell","year":"2010","journal-title":"Am J Prev Med"},{"issue":"2","key":"2020021108292336100_B2","first-page":"134","article-title":"Sickle cell disease: screening, diagnosis, management, and counseling in newborns and infants","volume":"7","author":"Berg","year":"1994","journal-title":"J Am Board Fam Pract"},{"issue":"9442","key":"2020021108292336100_B3","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/S0140-6736(04)17192-4","article-title":"Sickle-cell disease","volume":"364","author":"Stuart","year":"2004","journal-title":"Lancet"},{"issue":"5","key":"2020021108292336100_B4","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1002\/(SICI)1098-2272(1996)13:5<501::AID-GEPI6>3.0.CO;2-4","article-title":"Distribution of hemoglobinopathy variants by ethnicity in a multiethnic state","volume":"13","author":"Lorey","year":"1996","journal-title":"Genet Epidemiol"},{"issue":"21","key":"2020021108292336100_B5","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1056\/NEJMra0804411","article-title":"Pulmonary complications of sickle cell disease","volume":"359","author":"Gladwin","year":"2008","journal-title":"N Engl J Med"},{"key":"2020021108292336100_B6","unstructured":"National Heart Lung and Blood Institute. 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