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Sickle cell identified as pregnancy risk factor

A trio from the Jamaica campus of the University of the West Indies (UWI) have had their sickle cell disease research published this month in the open access journal One, the flagship of the Public Library of Science (PLoS).

Two of the authors, Monika Asnani and Marvin Reid, are from the UWI Tropical Medicine Research Institute, while Affette McCaw-Binns is from the UWI department of community health and psychiatry.

The researchers studied the extensive data provided by the Ministry of Health. Jamaican authorities must be notified of all maternal deaths.

The disease—predominantly a genetic legacy of colonial-era slavery—is ‘‘a consistent underlying cause’’ of death during pregnancy in Jamaica, their ten-year study noted.

The growing number of indirect deaths has negated the decreases in direct maternal deaths across Jamaica, they warned.

Women who inherited sickle cell disease—the most common genetic disease on the island—lost more babies during pregnancy, despite constantly improving access to high-risk antenatal care.

The situation was particularly acute for women living outside the Kingston area, where the UWI Sickle Cell Unit is located at the University Hospital of the West Indies.

‘‘Universal sickle cell disease screening in pregnancy in populations of African and Mediterranean descent is needed,’’ the authors found.

Regional centres need intensive care equipment, including ventilators, in order to help this high-risk population, the authors concluded.

They also emphasised the need for guidelines for managing pregnancies among women with sickle cell disease pregnancies and education of families carrying the genetic markers.

Their article, ‘‘Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007’’, was published earlier this month and is available online.