{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:31:55Z","timestamp":1793395915590,"version":"4.5.0"},"reference-count":42,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pregnancy in women with sickle cell disease (SCD) is associated with increased maternal and fetal morbidity and mortality. Outcomes vary widely owing to methodological limitations of clinical studies, but overall, hypertensive disorders of pregnancy, venothromboembolism, poor fetal growth, and maternal and perinatal mortality are increased globally. Few therapeutic interventions have been explored other than prophylactic and selective transfusion therapy. Unfortunately, existing data are limited, and it remains unclear whether prophylactic use of chronic transfusions will improve pregnancy outcomes. Management of pregnant women with SCD is best accomplished with a multidisciplinary team that includes a sickle cell expert and an obstetrician familiar with high-risk pregnancies. Women with SCD should have individualized care plans that outline management of acute pain and guidelines for transfusion therapy. Neonates require close monitoring for neonatal abstinence syndrome and hemolytic disease of the newborn. Ideally all young women with SCD will have a \"reproductive life plan\" developed as a component of preconception counseling and health promotion. Research leading to improved pregnancy management focused on diminishing adverse maternal and neonatal outcomes is overdue. International collaborations should be considered to improve subject recruitment and foster timely completion of clinical trials. Additional therapeutic interventions outside of transfusion therapy should be explored.<\/jats:p>","DOI":"10.1182\/hematology.2019000039","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T10:13:08Z","timestamp":1575627188000},"page":"359-366","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":85,"title":["Complications in pregnant women with sickle cell disease"],"prefix":"10.1182","volume":"2019","author":[{"given":"Kim","family":"Smith-Whitley","sequence":"first","affiliation":[{"name":"Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"12","key":"2019120610102508100_B1","doi-asserted-by":"crossref","first-page":"742","DOI":"10.14423\/SMJ.0000000000000900","article-title":"Maternal\/perinatal outcome in women with sickle cell disease: a comparison of two time periods","volume":"111","author":"Chang","year":"2018","journal-title":"South Med J"},{"issue":"9","key":"2019120610102508100_B2","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1002\/ajh.24790","article-title":"Implementation of multidisciplinary care reduces maternal mortality in women with sickle cell disease living in low-resource setting","volume":"92","author":"Asare","year":"2017","journal-title":"Am J Hematol"},{"issue":"3","key":"2019120610102508100_B3","doi-asserted-by":"crossref","first-page":"1470320316670444","DOI":"10.1177\/1470320316670444","article-title":"Volume regulatory hormones and plasma volume in pregnant women with sickle cell disorder","volume":"17","author":"Afolabi","year":"2016","journal-title":"J Renin Angiotensin Aldosterone Syst"},{"issue":"11","key":"2019120610102508100_B4","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1007\/s00277-016-2780-1","article-title":"Abnormal expression of inflammatory genes in placentas of women with sickle cell anemia and sickle hemoglobin C disease","volume":"95","author":"Baptista","year":"2016","journal-title":"Ann Hematol"},{"issue":"1","key":"2019120610102508100_B5","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/bjh.13270","article-title":"Pregnancy outcome in patients with sickle cell disease in the UK--a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease","volume":"169","author":"Oteng-Ntim","year":"2015","journal-title":"Br J Haematol"},{"issue":"5","key":"2019120610102508100_B6","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/1471-0528.13786","article-title":"Pregnancy outcomes in women with sickle-cell disease in low and high income countries: a systematic review and meta-analysis","volume":"123","author":"Boafor","year":"2016","journal-title":"BJOG"},{"issue":"2","key":"2019120610102508100_B7","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0029-7844(95)00367-3","article-title":"Pregnancy in sickle cell disease: experience of the Cooperative Study of Sickle Cell Disease","volume":"87","author":"Smith","year":"1996","journal-title":"Obstet Gynecol"},{"issue":"16","key":"2019120610102508100_B8","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1001\/jama.2016.18315","article-title":"Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force","volume":"317","author":"Henderson","year":"2017","journal-title":"JAMA"},{"issue":"16","key":"2019120610102508100_B9","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1001\/jama.2017.3439","article-title":"Screening for preeclampsia: US Preventive Services Task Force recommendation statement","volume":"317","author":"Bibbins-Domingo","year":"2017","journal-title":"JAMA"},{"key":"2019120610102508100_B10","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.preghy.2018.01.006","article-title":"Severe pre-eclampsia among pregnant women with sickle cell disease and HIV","volume":"11","author":"Prophet","year":"2018","journal-title":"Pregnancy Hypertens"},{"key":"2019120610102508100_B11","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ejogrb.2016.05.002","article-title":"Pregnancy in sickle cell-haemoglobin C (SC) disease. 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