Maternal and perinatal outcomes among haemoglobinopathy carriers: A systematic review

Suze Jans (1, 2) , Ank de Jonge (3) , Toine Lagro-Janssen (4)

1 Department Primary Care and Community Care
2 Community Genetics
3 Midwifery Science, EMGO Institute for Health and Care Research
4 Department Primary Care and Community Care

Background: With the introduction of screening programs for haemoglobinopathies, more women will be aware of their HbP status. Midwives and obstetricians need to know whether pregnant HbP carriers have any special needs besides the genetic risk. The objective was to investigate the hypothesis that being a carrier of HbP has no consequences for the health of pregnant women and the outcome of their pregnancies. Methods: A systematic search was carried out until august 2008 in the Cochrane Library; Medline; EMBASE and CINAHL databases. All references were inspected to identify further studies. The authors of key-publications were contacted for any unpublished research. Selection criteria: Cohort and case control studies, pregnant women with a singleton pregnancy. Exposure: HbAS or thalassaemia minor. Outcomes: urinary tract infection, anaemia, (pre-)eclampsia, gestational diabetes, premature labour, low birth weight, intra- uterine growth retardation, miscarriage, neonatal death, low apgar score, neural tube defects. Quality assessment and data extraction were carried out by two researchers. Results: 780 Studies were identified of which nine were included in the study. A protective effect of sickle cell trait was found for premature birth, low apgar score and perinatal mortality rate. No significant effect was found for low birth weight, growth retardation, urinary tract infection or high blood pressure. The risk of anaemia and bacteriuria was increased. Conclusions: The risks among pregnant HbP carriers are low. Midwives and obstetricians need to be aware of the risk of anaemia and urinary tract infection.

Mots clés: Medicine

Suze Jans, Ank de Jonge, Toine Lagro-Janssen. Maternal and perinatal outcomes among haemoglobinopathy carriers: A systematic review. International Journal of Clinical Practice, 2010, 64 (12), pp.1688. ⟨10.1111/j.1742-1241.2010.02451.x⟩. ⟨hal-00585812⟩