Factors Affecting Maternal Mortality in Pregnant Women With Sickle Cell Disease in Ahvaz, Iran: A 10-Year Epidemiological Study

In sickle cell disease, red blood cells are sickle shaped and consequently lose their ability to carry oxygen, which may cause vessel blockage. Pregnancy in the setting of classic sickle cell disease could be extremely dangerous for both mother and fetus. The aim of this study was to determine the effective factors related to the maternal mortality among pregnant women with sickle cell disease. In this descriptive study conducted with data from 41 hospital records of women with sickle cell disease from 2001 to 2011, various data such as demographic, midwifery, and laboratory test information were recorded in a questionnaire. The relationship between this information and sickle cell disease was assessed. Descriptive statistics, analysis of variance, Fisher exact test, and chi-square test were used in the data analyses. The mean maternal age was 27.60 ± 6.37 years. The hemoglobin level at hospital admission was 8.9 ± 1.61 g/dL for the survivors and 7.73 ± 1.19 g/dL for the deceased patients (P < 0.05). All the patients with the sickle cell trait, 73% of the patients with sickle cell disease, and 50% of the patients with sickle cell-thalassemia disease survived (P < 0.05). The gestational age of the deceased patients was lower than that of the survivors (34.12 vs. 35.81 weeks, P = 0.08). Ultimately, we can conclude that the hemoglobin level at the time of admission and before delivery, the type of disease, gestational age, and transfusion could be effective factors of patient mortality.