ABSTRACT
The primary objective of this study was to determine whether having the sickle cell
trait is independently associated with preeclampsia. We performed a retrospective
cohort study of 1998 pregnant patients who either did or did not have the sickle cell
trait. All patients were screened for the sickle trait using the “Sickledex” test.
Data on neonatal and maternal outcome, including preeclampsia, and potential confounding
variables were abstracted from medical records. Unadjusted, stratified, and multiple
logistic regression analyses were used to identify interactions, and confounding between
multiple variables and the association between sickle cell trait and preeclampsia.
With an anticipated 6.5% rate of preeclampsia, and α = 0.05, this cohort study has
80% power to detect a relative risk (RR) of 2.3 for preeclampsia. Univariate analysis
revealed that the two cohorts were similar with regard to primiparity, maternal age,
chronic diseases, birth weight, and gestational age at delivery, but the sickle cell
trait cohort was more likely to have gestational diabetes and had a higher mean body
mass index (BMI). In the univariate analysis, the sickle cell trait cohort was not
at increased risk for preeclampsia [unadjusted RR = 0.5, 95% CI (0.2-1.6)]. After
controlling for potential confounding variables with logistic regression analysis,
sickle trait was not independently associated with preeclampsia [adjusted RR = 0.5,
95% CI (0.2- 1.6)]. In contrast to prior work, these data suggest that the sickle
cell trait is not an independent risk factor for preeclampsia or postpartum complications.
In fact, the data are more consistent with the sickle trait being protective for developing
preeclampsia.
KEYWORD
Preeclampsia - sickle cell trait - risk
