Abstract W P138: Pregnancy Associated Cerebral Ischemia in Women with Sickle Cell Disease
Background: Cerebral ischemia is commonly seen in patients with sickle cell disease but little information is available regarding such occurrence during pregnancy.
Objective: To determine the rates of pregnancy associated cerebral ischemia in women with sickle cell disease and affect on outcome of pregnancy.
Methods: We analyzed data collected as part of the Cooperative Study of Sickle Cell Disease, which was a multicenter, prospective study on the natural history of sickle cell disease. A total of 1043 adolescent and 1183 adults were enrolled in phase 1 of the study period 1978-1988. Data regarding pregnancy and outcome was ascertained throughout the follow-up period. We tested the effect of pregnancy associated cerebral ischemia as an interaction in the multivariate analysis assessing the effect of predictors on abortion or miscarriage.
Results: Of the 1024 women enrolled, 297 (29%) women experienced one or more pregnancy. Thirteen of the 297 women experienced an episode of cerebral ischemia during pregnancy. Patients with pregnancy associated cerebral ischemia had a higher rate of previous history of stroke (9 of 13 versus 107 of 284, p=0.01). There was a trend towards higher rate of pre-eclampsia among patients with cerebral ischemia (3 of 13 versus 28 of 284, p=0.1). A total of 102 of 297 first pregnancies resulted in abortion or miscarriage. After adjusting for age, history of previous stroke, and alcohol use, the interaction between pregnancy associated cerebral ischemia and abortion or miscarriage was not significant (p=0.2).
Conclusions: There appears to be high rates of cerebral ischemia and abortion or miscarriage among pregnant women with sickle cell disease but occurrence of cerebral ischemia does not influence subsequent abortion or miscarriage.
Author Disclosures: A.I. Qureshi: None. M.M. Adil: None. T.T. Zafar: None. M.K. Suri: None.
- © 2014 by American Heart Association, Inc.