Neonatal outcome in mothers with sickle cell disease compared to neonatal outcome in mothers without sickle cell disease at a tertiary care facility

Abstract Background: Sickle cell illness can complicate pregnancy. Vascular blockage in placenta can result in villous fibrosis, necrosis, and infarction. This can affect uteroplacental circulation, which can have a negative impact on fetus’s health and cause persistent hypoxia. Objective: To compare neonatal outcome of sickling positive mother and nonsickling mother. Materials and Methods: A cross-sectional and comparative study was conducted among 100 neonates. There were two groups of mothers. First group of 50 mothers with sickle cell disease (SCD) and second of 50 mothers without SCD (non-SCD). Detailed history, thorough physical examination, measurements of the neonate’s, assessment of vital signs, various laboratory tests, and sickling solubility test within 48 h of birth were performed. Results: Both groups were comparable for age, education, social class, body mass index, and history of abortion ( P > 0.05). Employed women were significantly more in SCD group compared to non-SCD group ( P < 0.05). Proportion of anemia and lower segment cesarean section rate were significantly more in SCD group compared to non-SCD group ( P < 0.05). Mean hemoglobin was significantly lower in women with SCD compared to women with sickle cell trait and women with non-SCD ( P < 0.05). Proportion of preterm was comparable in two groups ( P > 0.05). However, proportion of low birth weight, low Appearance, Pulse, Grimace, Activity and Respiration score, admission to neonatal intensive care unit, and adverse fetal outcome were significantly more in SCD group compared to non-SCD group ( P < 0.05). Conclusion: Maternal and fetal complications such as preeclampsia, eclampsia, anemia, prematurity, low birth weight, intrauterine growth retardation, IUD, stillbirth, and early neonatal death are significantly higher in pregnant sickle cell patients. Close supervision of these pregnancies with a multidisciplinary approach between hematologist, obstetrician, and pediatrician is essential.