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Sickle cell disease is known to be associated with worse pregnancy outcomes and higher maternal mortality. However, a new study shows that racial disparities significantly contribute to adverse pregnancy outcomes in Black women.

Sickle cell disease (SCD) is more likely to affect people of African descent. Additionally, it is known that SCD significantly increases the risk of pregnancy-related complications like sepsis, venous embolism, intrauterine growth restriction, and other issues. Early studies have shown that maternal mortality rates are much higher in SCD patients than in the general population. Between 1998 and 2008, the U.S. maternal mortality rate in SCD was 7.2 to 16 deaths per 10,000 SCD pregnancies, whereas this rate was 1.3 deaths in the general population. However, a new study published in JAMA Network Open shows significantly higher maternal morbidity and mortality rates in Black women due to racial disparities.

Racial Disparities Cause Higher Maternal Morbidity and Mortality in Blacks

This cross-sectional study included data from 5,401,899 deliveries, including 3901 among those living with SCD. Of the total deliveries, 742,164 were among Black patients. Generally, Black patients were younger and more likely to have public insurance. The study found that the maternal mortality rate among Black pregnant people with SCD was 26 times higher than in the non-Black control group and 10 times higher than that of Black people without SCD.

The study concluded that, on average, racial disparities increased the risk of adverse pregnancy outcomes in Black people by 28.9%. Racial disparities increased the risk of acute kidney failure by 40–50%, intrauterine fetal demise by 47.8%, and eclampsia by 42.1%. 

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The Bottom line

The study found that racial disparities are causing much higher maternal mortality among Black people living with SCD than among their Black counterparts without SCD and non-Black counterparts. They are more likely to experience severe maternal mortality and life-threatening complications. There is an urgent need to find ways to reduce these racial disparities. It is vital to carry out further studies to understand the reasons for these racial disparities and make appropriate changes to the healthcare system.

Source:

Early, M. L., Eke, A. C., Gemmill, A., Lanzkron, S., & Pecker, L. H. (2023). Severe maternal morbidity and mortality in sickle cell disease in the National Inpatient Sample, 2012-2018. JAMA Network Open, 6(2), e2254552. https://doi.org/10.1001/jamanetworkopen.2022.54552