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Poster Session 2

Category: Medical/Surgical/Diseases/Complications

Poster Session 2

(647) Impact of Sickle Cell Disease Genotype on Severe Maternal Morbidity and Readmission

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Presenting Author(s)

Salimah Navaz Gangji, DO (she/her/hers)

Resident Physician
Eastern Virginia Medial School at Old Dominion University
Norfolk, Virginia, United States

Coauthor(s)

GS

Grace Spencer, BS, MS

Eastern Virginia Medical School at Old Dominion University
EVMS OBGYN, Virginia Health Sciences at Old Dominion University, Virginia, United States

Submitting Author(s)

Tetsuya Kawakita, MD, MS (he/him/his)

Associate Professor
Eastern Virginia Medical School Department of Obstetrics and Gynecology, Macon & Joan Brock Virginia Health Sciences at Old Dominion University
Norfolk, Virginia, United States

Objective:
To examine the maternal outcomes according to sickle cell disease (SCD) genotypes.

Study Design:
This was a retrospective cohort study using the Healthcare Cost and Utilization Project (HCUP) National Readmissions Database from 2018 to 2022. Patients were categorized by genotype: no SCD, sickle cell trait, hemoglobin SS (SS) disease, hemoglobin SC (SC) disease, and sickle-thalassemia. The primary outcome was CDC-defined severe maternal morbidity (SMM), excluding sickle cell crisis and transfusion. Secondary outcomes included postpartum readmission within 42 days, transfusion, and sickle cell crisis. Modified Poisson regression was used to calculate adjusted relative risks (aRR) with 95% confidence intervals (CI), adjusting for relevant confounders.

Results:
Among 7,990,355 patients, 55,863 (0.7%) had sickle cell trait, 4,958 (0.06%) had SS disease, 585 (0.01%) had SC disease, and 760 (0.01%) had sickle-thalassemia. Maternal demographics, comorbidities, and pregnancy complications varied across genotypes (Table 1). Compared to patients without SCD (0.9%), rates of SMM were higher in those with sickle cell trait (1.6%; aRR 1.44, 95% CI 1.35–1.54), SS disease (6.7%; aRR 5.86, 95% CI 5.28–6.51), SC disease (7.9%; aRR 5.58, 95% CI 4.19–7.45), and sickle-thalassemia (4.1%; aRR 3.77, 95% CI 2.67–5.33) (Table 2). Similar trends were observed for readmission and transfusion. Compared to SS disease (16.5%), the risk of sickle cell crisis was higher in SC disease (21.7%; aRR 1.29, 95% CI 1.10–1.52) and lower in sickle-thalassemia (10.4%; aRR 0.68, 95% CI 0.55–0.85).

Conclusion:
Maternal outcomes vary significantly by SCD genotype. While all genotypes were associated with increased risk of SMM, patients with SC disease had the highest risk despite historically being considered less severe. Sickle cell trait, though often viewed as benign, was also associated with excess risk. These findings underscore the need for genotype-specific risk counseling, close monitoring, and individualized care pathways during pregnancy.