ArticleAmerican journal of hematology2022
Pregnancy outcomes with hydroxyurea use in women with sickle cell disease.
Article in American journal of hematology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Position statement on the management of pregnancy in sickle cell disease.The Australian & New Zealand journal of obstetrics & gynaecology · 2025Guideline
- Effects of hydroxyurea on fertility in male and female sickle cell disease patients. A systemic review and meta-analysis.PloS one · 2024Pooled it
- Effectiveness of preimplantation genetic testing in sickle cell disease: insights from a single-center experience.Journal of assisted reproduction and genetics · 2026Article
- Gynecologic and Reproductive Health in Patients with Sickle Cell Disease: Underrecognized Challenges and Care Management Opportunities.Journal of clinical medicine · 2026Review
- Sickle Cell Disease: Treatment Options of the Past, Present, and Future.The American journal of nursing · 2026Review
- Management of Chronic Myeloid Leukemia During Pregnancy: Review of Evidence and Treatment Algorithm.Clinical lymphoma, myeloma & leukemia · 2026Review
- The right patient, the right treatment: tailoring sickle cell disease care.Hematology. American Society of Hematology. Education Program · 2025Review
- Antenatal medication management for women with sickle-cell disease: A systematic review.Pregnancy (Hoboken, N.J.) · 2025Review
- Neuroprotective, anti-inflammatory, and analgesic activity of palmitoylethanolamide in sickle cell mice.Blood advances · 2025Article
- Hematologic Complications of Pregnancy.European journal of haematology · 2025Review
- Patient-reported pregnancy loss and maternal complications: Insights from the sickle cell disease implementation consortium.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Thalassemias and Sickle Cell Diseases in Pregnancy: SITE Good Practice.Journal of clinical medicine · 2025Article
- The histone deacetylase inhibitor CT-101 flips the switch to fetal hemoglobin expression in sickle cell disease mice.PloS one · 2025Article
- CureSCi Metadata Catalog-Finding and harmonizing studies for secondary analysis of hydroxyurea discontinuation in sickle cell disease.PloS one · 2025Article
- The Current Role of Hydroxyurea in the Treatment of Sickle Cell Anemia.Journal of clinical medicine · 2024Review
- Prescribing Hydroxyurea in Sickle Cell Disease Patients: The Pattern and Association with Co-Prescribed Medications Used to Manage the Disease Complications.Journal of clinical medicine · 2024Article
- Impact of hydroxyurea on follicle density in patients with sickle cell disease.Blood advances · 2024Article
- Sickle cell disease and infertility risks: implications for counseling and care of affected girls and women.Expert review of hematology · 2024Review
- Article
- Managing sickle cell disease and related complications in pregnancy: results of an international Delphi panel.Blood advances · 2024Article
Corrections and comments
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Authors and funding
11 authors at 9 institutions in 1 country.
Funding
Abstract
Hydroxyurea reduces pain crises, acute chest syndrome, and blood transfusions in sickle cell disease (SCD), but potential detrimental effects on fertility and birth outcomes impede its use. Data on the effects of hydroxyurea taken for SCD during conception and pregnancy are scarce. The Sickle Cell Disease Implementation Consortium collected self-reported pregnancy history, corresponding hydroxyurea use, and pregnancy outcomes in women with SCD in the clinical setting. Among 1285 women 18-45 years of age, 737 (57.4%) reported 1788 pregnancies (1079 live births, 394 miscarriages, 40 stillbirths, 207 abortions, 48 current pregnancies, and 20 missing outcomes) of which 241 (15.9%) live births, miscarriages or stillbirths were conceived while on hydroxyurea. In univariate analyses, pregnancy number more than three, severe sickle genotype, history of stillbirth or miscarriage, and chronic kidney disease at enrollment were covariates significantly associated with a pregnancy ending in miscarriage or stillbirth. After adjustment for covariates and additional SCD severity markers in multivariate analyses, hydroxyurea use during conception and pregnancy, but not during conception only, was associated with an increase in the odds ratio (OR) of miscarriage or stillbirth (OR 2.21, 95% confidence interval [CI] 1.40-3.47). In analyses of live birth outcomes, hydroxyurea use during conception and pregnancy was associated with birth weight < 5.5 pounds in full-term infants (OR 2.98, 95% CI 1.09-7.38) but not with prematurity or serious medical problems at birth. These findings suggest that hydroxyurea use may be safe up to the time of conception, but that clinicians should continue to advise caution regarding use during pregnancy.
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Registered trials
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