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Southern medical journal · Apr 2021
Review Comparative StudyEvidence for Prophylactic Transfusion during Pregnancy for Women with Sickle Cell Disease.
- Julie R Whittington, Everett F Magann, Songthip T Ounpraseuth, Jon N Chang, Dayna D Whitcombe, and John C Morrison.
- From the Departments of Obstetrics and Gynecology and Biostatistics, University of Arkansas for the Medical Sciences, Little Rock, and the Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson.
- South. Med. J. 2021 Apr 1; 114 (4): 231-236.
AbstractThe objective of this study was to examine prior studies on maternal and neonatal outcomes with prophylactic compared with emergent blood transfusion in pregnant women with sickle cell disease. A review of the literature was performed. Twenty-one articles were identified and included in the analysis. A generalized linear mixed-effects model was used to analyze the outcomes. Pregnancy outcomes assessed were preeclampsia, pneumonia, pyelonephritis, pain crises, intrauterine growth restriction, neonatal death, perinatal death, and maternal mortality. Women who underwent emergent transfusion were more likely than women who underwent prophylactic transfusion to have the following adverse perinatal outcomes: preterm delivery (adjusted odds ratio [aOR 2.04], 95% confidence interval [CI] 1.14-3.63), pneumonia (aOR 2.98, 95% CI 1.44-6.15), pain crises (aOR 1.67, 95% CI 1.18-2.38), and perinatal death (aOR 1.84, 95% CI 1.06-3.07). Prophylactic transfusion should be reexamined as a potentially beneficial approach to the management of sickle cell disease in pregnancy.
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