Breanna Smith

April 4, 2015
Tamera Nef
Biology 1615 Lab
Final Paper
Introduction
Sickle Cell Disease (SCD) is a hereditary problem that afects the
red blood cells in a womans body. This is most common in women of
an African decent. Because of that, there was a study that took place in
Ghana Africa. The background of this disease includes many cases of
pregnant women with Sickle Cell Disease (SCD) and the outcomes of
the baby and mother.
This history of this subject is that there are many cases of
women who pass away during (or before) labor when they have SCD.
Other cases include babies being born with deformities. SCD is the
most common monogenic disorder (Wilson et al), having said that, this
afects a lot of pregnant women worldwide, which is one of the reasons
it was chosen to be studied on. Another reason this topic was picked, is
due to the fact they wanted to know the risks SCD causes on the fetus.
Does it induce preterm labor to the mom, or put any additional stress
on the baby? All these questions are ones that the researchers had
while conducting this study.
The people at Korle-Bu Teaching Hospital (KBTH) want to see if
they can get to the bottom of the SCD burdens during pregnancy and
in the process, reduce the number of mortality of baby and mother in
the African country. Before they even started the study, they knew that
these women were already at an increased risk of urinary tract
infections, anemia, and gestational diabetes, so they took that in to
considerations when gathering all the needed information.
Researching this topic would bring much value in knowing what
to expect if you are one of the women who have SCD. This way, you

can read up on the diferent studies done and find out the results. Also,
if you know you have this, you will see that it is hereditary and be
aware of the likelihood that your daughters might have it.
Even though a hypothesis was not stated, the researchers did
say that they are trying to educate (or prove) to us that there are
people all around world who are sufering from this disease. There isnt
much anyone can do to help the situation. Finding out the results will
determine how much of the African population in Ghana will sufer from
SCD. Which will in turn tell us about the reproduction limitations the
people of Ghana might face.
Materials and Methods
The KBTH conducted a study in which they compared patients
who had SCD and who also received prenatal care against those who
didnt have any genetic disorder (those without hemoglobinopathies.
Also the group commonly referred to as the comparison group). This
study went from 2007-2008. The criteria was the women had to be
over 18 years of age, have neither human immunodeficiency virus
(HIV) or Acquired immunodeficiency syndrome (AIDS). If they passed
those certain elements, they were able to participate in the study.
The diferent techniques they used were watching the mothers
as they grew to full term. The researchers watched for signs of
premature rupture of membrane (PROM) , pregnancy induced
hypertension (PIH) , and other pre-term disorders the women could
have acquired. Everything was recorded, no matter how minute, and
was put towards the results.
Out of the nearly 18,000 women who were pregnant, only 1.42%
(roughly about 253 participants) were diagnosed with SCD. All together
those women birthed a little over 18,00 babies. Sadly though, there
was roughly a seven and a half percent mortality rate, all of which
were women who had the sickle cell disease.

While looking at their notes after the study was done, the
researchers noticed that there was a higher rate of low birth weight
(LBW) babies born to women who had SCD than those in the
comparison group. Another thing they saw was that nearly half of the
SCD women had cesarean section (c-section) at the time of birth
compared to only the 33% of the women from the comparison group,
which came as a shock to the researchers.
Results:
The results showed us that women who are healthy have major
advantage compared to those women who have any sort of disease.
This study showed us that having a complication with your body,
causes problems to you and your fetus if and when the mother decides
to become pregnant. Before KBTH started this study, they had guessed
that this would be the outcome, but by gathering enough information
and testing all that they could, the results showed they were correct
from the beginning.
The one thing that came as a shock to the researchers, that was
previously stated, was most of the participants had a C-section. That
was something they did not predict would happen.
Discussion
Since the researchers did not state a hypothesis, it was unclear
as to if they proved or disproved it. But from what they mentioned,
they did get their results back and are able to see how common the
SCD gene is, and were able to see the probability of how many African
women will have or inherit this gene, based of the group they studied.
If they chose to continue the study, they could see how this might
afect the African population in 50 years. That way the country would
know if it would grow in population, shrink, or stay the same, and they
could prepare for it.
The conclusion they came to is there isnt much we can do for
those women who has this disease. They will go thorough a lot

physically, and emotionally. Sometimes their babies will come out fine,
while others will have babies who have some sort of mutation or
problem. .
Some of the limitations that the article mentioned was that some
of their charts did not include 100% of their data, which could have
skewed the results, ending up making them a little bias towards one
side. Another limitation they mentioned was that they did not get any
information after the baby was born. If they had more information postbirth of mother and baby, they could add to their study and that could
have changed the outcome of their results.

Works Cited
Wilson,NanaO.,andDrissAdel."PregnancyOutcomesamongPatientswithSickleCell
DiseaseatKorleBuTeachingHospital,Accra,Ghana:RetrospectiveCohortStudy."
PregnancyOutcomesamongPatientswithSickleCellDiseaseatKorleBuTeaching
Hospital,Accra,Ghana:RetrospectiveCohortStudy.ASTMH,n.d.Web.04Mar.2015.
<http://www.ajtmh.org/content/86/6/936.full?sid=01836502260142ec9291
b2d38fa968b0>