Maternal and perinatal outcomes of sickle cell anaemia among peri-partum women: A systematic review and meta-analysis
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Background: Sickle cell anaemia(SCA) is inherited as an autosomal co-dominant trait, with heterozygous individuals carrying the sickle cell trait and homozygous individuals having SCA. The clinical severity of SCA varies widely, influenced by genetics and environmental factors, including parental inheritance and interracial marriages. This study aims to comprehensively review existing research on how SCA is managed and what outcomes women of childbearing age experience in Nigeria. Method: A systematic review was conducted by searching major databases (PubMed, Medline, Embase, and Web of Science) for studies on managing SCA in women of childbearing age and their pregnancy outcomes. Titles and abstracts were screened, 24 relevant articles were retrieved, and data was extracted on study background, management approaches, and pregnancy outcomes. Results: Sickle cell management was reported in 9 studies while outcomes were reported in 15 studies originating from 8 countries. Management of SCA was reported as preventive (5 studies), supportive (6 studies), curative (2 studies) and in pregnancy (4 studies). Perinatal outcomes reported were IUGR (10 studies, incidence rates range 5.1 - 50%), perinatal mortality (6, 2.1 - 20.9%), premature birth (15, 16.3 - 75.4%), low birth weight (11, 3.5 - 84.6%), still birth (11, 2.5 - 25.5%) and neonatal mortality (6, 2.5 - 15.6%). Maternal outcomes reported were pre-eclampsia (14 studies, 7.5 - 56%), eclampsia (7 studies, 1 - 33.3%), postpartum haemorrhage (5, 6.6 - 20%), caesarean deliveries (11, 21.6 - 80%), infection (12, 1.5 - 41.6), severe anaemia (7, 8.4 - 43.9%), and maternal mortality (10, 0.3 - 20%). Conclusion: This study shows that, despite advancements in management strategies, women with SCA continue to experience an excessive burden of adverse maternal and perinatal outcomes, highlighting a critical area for further research and potentially targeted interventions.
