Maternal and Fetal Outcomes of Pregnancies Complicated by Sickle Cell Disease at a Tertiary Hospital in Northwestern Nigeria: A 10-Year Retrospective Cohort Study

Abstract Background: Pregnancy complicated by sickle cell disease (SCD) is associated with an increased risk of adverse maternal and fetal outcomes, particularly in low-resource settings. This study evaluated the maternal and fetal outcomes of pregnancies complicated by SCD at a tertiary hospital in northwestern Nigeria. Methods: This retrospective study reviewed pregnancies complicated by SCD managed at Usmanu Danfodiyo University Teaching Hospital, Sokoto, between January 1, 2014, and December 31, 2023. Demographic characteristics, obstetric and medical complications, mode of delivery, and maternal and neonatal outcomes were extracted from patients' medical records and analysed using IBM SPSS Statistics version 21. Results: During the study period, there were 29,674 deliveries, of which 65 (0.2%) occurred in women with SCD. Fifty-one (78.5%) women had HbSS genotype, while 14 (21.5%) had HbSC genotype. The mean maternal age was 22.7 ± 4.1 years. Most women (84.6%) received antenatal care at the study facility, with 86.1% booking during the second trimester. The most common maternal complications were anemia (90.8%), vaso-occlusive crises (81.5%), malaria (49.2%), hypertensive disorders of pregnancy (20.0%), urinary tract infection (12.3%), premature rupture of membranes (4.6%), and abruptio placentae (1.5%). Vaginal delivery occurred in 76.9% of cases, while 20.0% delivered preterm. Low birth weight was observed in 57.0% of neonates. Common neonatal complications included intrauterine growth restriction (23.1%), prematurity (20.0%), and birth asphyxia (4.6%). Maternal mortality was 3.0%, while perinatal mortality was 10.8%. Conclusion: Pregnancy complicated by SCD remains associated with substantial maternal and neonatal morbidity and mortality. Early antenatal booking, multidisciplinary care, effective preconception counseling, and skilled intrapartum and postnatal management are essential to improve pregnancy outcomes among women with SCD. Keywords: sickle cell disease; pregnancy; maternal outcome; fetal outcome; perinatal mortality; Nigeria.