What question did this study set out to answer?

This study investigates the incidence and factors associated with maternal mortality in pregnant women with sickle cell disease.

April 16, 2026Open Access

Maternal Mortality in Sickle Cell Disease: A 3-year Clinical and Epidemiological Review from a Tertiary Care Center in Central India

Key Points

This study investigates the incidence and factors associated with maternal mortality in pregnant women with sickle cell disease.
Conducted a cross-sectional observational study at Government Medical College, Nagpur.
Included all pregnant women with confirmed sickle cell disease (SCD) from January 2022 to December 2024.
Analyzed maternal outcomes, including mortality and complications, as well as pregnancy outcomes such as stillbirth and preterm delivery.
27 maternal deaths observed among 900 SCD obstetric admissions, accounting for 11.89% of maternal deaths during the study period.
74.07% of maternal deaths were among unbooked referrals.
Mortality was highest in women aged 26-30 years, with 62.95% occurring postpartum.
Leading causes of death included vaso-occlusive crises and pulmonary embolism.

Abstract

Background: Sickle cell disease (SCD), a hereditary hemoglobinopathy, is associated with substantial maternal morbidity and mortality.Physiological changes of pregnancy often exacerbate complications in women with SCD, leading to poor maternal and fetal outcomes.This study evaluates the incidence and determinants of maternal deaths among pregnant women with SCD at a tertiary care center in Central India.Materials and methods: A cross-sectional observational study was undertaken at Government Medical College, Nagpur, from January 2022 to December 2024.All obstetric patients with confirmed SCD were included.Maternal outcomes (mortality, complications such as acute chest syndrome, preeclampsia, and vaso-occlusive crisis) and pregnancy outcomes (abortion, stillbirth, preterm delivery, mode of delivery, hemoglobin levels, and transfusion needs) were analyzed.Results: Out of 900 obstetric admissions with SCD, 27 maternal deaths were recorded in homozygous cases (HbSS), contributing 11.89% of all maternal deaths during the study period.Nearly three-fourths of the deaths (74.07%) occurred among unbooked referrals.The highest mortality was observed in women aged 26-30 years (48.14%), with 62.95% of deaths occurring postpartum.Vaso-occlusive crises and pulmonary embolism were the leading causes of death.Severe anemia at presentation was noted in 18.5% of cases.Conclusion: Maternal deaths in SCD remain high, particularly among unbooked and late-referred patients.Strengthening antenatal surveillance, timely diagnosis, multidisciplinary care, and postnatal follow-up are crucial to reducing preventable mortality in this high-risk group.

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