Pregnancy in sickle cell trait: what we do and don't know

Br J Haematol. 2020 Aug;190(3):328-335. doi: 10.1111/bjh.16518. Epub 2020 Feb 17.

Abstract

Sickle cell trait (SCT) is the carrier state for sickle cell disease that results from the HBB rs334 missense mutation (p.Glu6Val) in the β-globin chain of haemoglobin. While not associated with any impact on life expectancy, it has been established that SCT is associated with an increased risk of both venous thromboembolism (and in particular, pulmonary embolism) and chronic kidney disease. It is largely unknown what short- or long-term effect, if any, pregnancy has upon the risk or outcomes of these disorders. In addition, SCT has been linked with various adverse outcomes in pregnancy, ranging from maternal complications such as elevated risk of bacteriuria to potentially life-threatening entities such as pre-eclampsia and prematurity. In these scenarios also, no clear association with SCT has been established. Given the high worldwide prevalence of SCT, further studies addressing these issues are warranted.

Keywords: chronic kidney disease; pregnancy; sickle cell trait; venous thromboembolism.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Abortion, Spontaneous / etiology
  • Bacteriuria / etiology
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced / etiology
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Obstetric Labor, Premature / etiology
  • Pregnancy
  • Pregnancy Complications / etiology*
  • Pregnancy Complications / mortality
  • Pregnancy Complications, Hematologic
  • Pregnancy Outcome
  • Renal Insufficiency, Chronic / etiology
  • Sickle Cell Trait / complications*
  • Venous Thromboembolism / etiology*