U.S. 28.8% Maternal Mortality, Morbidity Increased in Sickle Cell Disease

The median of 28.9 percent of the increased risk of deliveries to people with SCD was explained by racial disparities.

According to a study published online in JAMA Network Open, the risk for maternal mortality and severe maternal morbidity is increased for people with sickle cell disease (SCD) compared with those without SCD.

Macy L. Early, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a cross-sectional study to examine adverse pregnancy outcomes among patients with SCD, comparing Black patients with SCD to Black patients without SCD and a non-Black control population.

Data from the National Inpatient Sample, a nationally representative sample of 20 percent of acute hospital admissions in the United States, were included for 5,401,899 deliveries, including 3,901 among people with SCD and 742,164 among Black people.

The researchers found that among people with SCD, the maternal mortality rate was 26 times greater than in the non-Black population and was more than 10 times greater than among Black pregnant people without SCD (13.3, 1.2, and 0.5 per 10,000 deliveries for SCD, Black race, and non-Black control, respectively).

SCD deliveries had higher odds of severe maternal morbidity than the control group (adjusted odds ratio, 7.22), especially cerebrovascular events and thromboembolism (adjusted odds ratios, 22.00 and 17.34, respectively).

A median of 28.9 percent of the increased risk in deliveries to people with SCD was explained by racial disparities, as was 40 to 50 percent of the increased risk for acute kidney failure, intrauterine fetal demise, and eclampsia (excess risks, 56.9, 47.8, and 42.1 percent, respectively).

“Our findings compel focused scientific, clinical, and political effort to improve outcomes for pregnant people with SCD,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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