TY - JOUR
T1 - Severe pre-eclampsia among pregnant women with sickle cell disease and HIV
AU - Prophet, Javon
AU - Kelly, Kalifa
AU - Domingo, Julian
AU - Ayeni, Helen
AU - Mekouguem, Xaviera Pascale Djoko
AU - Dockery, Breana
AU - Allam, Farida
AU - Kaur, Manvir
AU - Artis, Javon
AU - Spooner, Kiara K.
AU - Salemi, Jason L.
AU - Olaleye, Omonike
AU - Salihu, Hamisu M.
N1 - Funding Information:
Research funding support was provided by the U.S. Department of Health and Human Services, Health Resources and Services Administration for the Maternal and Child Health Pipeline Training Program: TSU-BCM Maternal and Child Health Student Training for Academic Readiness and Success (MCH STARS) Undergraduate Fellowship Program, Grant No: T16MC29831.
Publisher Copyright:
© 2018 International Society for the Study of Hypertension in Pregnancy
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - Objective: The relationship between sickle cell disease (SCD) and severe pre-eclampsia is poorly established. It is also unknown whether the occurrence of HIV infection among women with SCD modifies their risk level for severe pre-eclampsia. We hypothesized that pregnant women with SCD are at an elevated risk for severe pre-eclampsia as a result of heightened endothelial damage; and the combination of SCD-HIV augments the inflammatory processes of endothelial damage leading to amplified risk for severe pre-eclampsia. Study design: We analyzed more than 57 million pregnancy-related hospitalizations and births in the US from January 1, 2002 through December 31, 2014. Main outcome measures: We applied multivariable survey logistic regression to generate odds ratios for the association between SCD, HIV and SCD-HIV status and severe pre-eclampsia with adjustment for potential confounders. Results: Of the total 57,326,459 pregnant women, 57,198,505 (99.78%) did not have SCD or HIV, 73,064 (12.7 per 10,000) had HIV only, 54,890 (9.58 per 10,000) had SCD only and 222 (0.39 per 100,000) had both SCD and HIV. Mothers with SCD and HIV-SCD experienced a significant elevation in risk for severe pre-eclampsia of about 60% (OR = 1.61; 95% CI = 1.44, 1.79) and of more than 300% (OR = 4.28; 95% CI = 1.35, 13.62) respectively. Conclusion: In the largest study on SCD and pre-eclampsia in the world, we established SCD to be strongly associated with severe pre-eclampsia. Another unique finding is the synergistic effect of amplified risk for severe pre-eclampsia among mothers with the combined SCD-HIV status.
AB - Objective: The relationship between sickle cell disease (SCD) and severe pre-eclampsia is poorly established. It is also unknown whether the occurrence of HIV infection among women with SCD modifies their risk level for severe pre-eclampsia. We hypothesized that pregnant women with SCD are at an elevated risk for severe pre-eclampsia as a result of heightened endothelial damage; and the combination of SCD-HIV augments the inflammatory processes of endothelial damage leading to amplified risk for severe pre-eclampsia. Study design: We analyzed more than 57 million pregnancy-related hospitalizations and births in the US from January 1, 2002 through December 31, 2014. Main outcome measures: We applied multivariable survey logistic regression to generate odds ratios for the association between SCD, HIV and SCD-HIV status and severe pre-eclampsia with adjustment for potential confounders. Results: Of the total 57,326,459 pregnant women, 57,198,505 (99.78%) did not have SCD or HIV, 73,064 (12.7 per 10,000) had HIV only, 54,890 (9.58 per 10,000) had SCD only and 222 (0.39 per 100,000) had both SCD and HIV. Mothers with SCD and HIV-SCD experienced a significant elevation in risk for severe pre-eclampsia of about 60% (OR = 1.61; 95% CI = 1.44, 1.79) and of more than 300% (OR = 4.28; 95% CI = 1.35, 13.62) respectively. Conclusion: In the largest study on SCD and pre-eclampsia in the world, we established SCD to be strongly associated with severe pre-eclampsia. Another unique finding is the synergistic effect of amplified risk for severe pre-eclampsia among mothers with the combined SCD-HIV status.
KW - HIV
KW - Pre-eclampsia
KW - Pregnancy
KW - Sickle cell disease
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U2 - 10.1016/j.preghy.2018.01.006
DO - 10.1016/j.preghy.2018.01.006
M3 - Article
C2 - 29523281
AN - SCOPUS:85043368029
VL - 11
SP - 87
EP - 91
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
SN - 2210-7789
ER -