Third trimester and early postpartum period of pregnancy have the greatest risk for ACS in women with SCD

Abstract

Pregnancy is a life‐threatening occurrence in women with sickle cell disease (SCD), with increased odds of maternal and perinatal mortality compared to pregnant women without SCD.1 During pregnancy, women with SCD can also experience SCD related maternal morbidities, including acute vaso‐occlusive pain episode, acute chest syndrome (ACS), and venous thromboembolism with expected increased incidence rates when compared to not being pregnant.2 We previously demonstrated in a case series that 87% of all maternal deaths were due to ACS, with almost 80% of episodes preceded by an acute pain event.3 In another prospective study, we demonstrated increased incidence rates of acute pain and ACS in pregnant women with SCD4 compared to historical non‐pregnant women with SCD.5 As a planned follow‐up to our prospective cohort study, we extended the outcome in our pre‐existing cohort of pregnant women with SCD4 to determine the impact of pregnancy on acute pain events pre‐ and postpartum. We tested the hypothesis that pregnant women with SCD have higher incidence rates of acute pain requiring hospitalization and ACS during pregnancy compared to one‐year postpartum