Observational studyBMC pediatrics2026
Asthma and overt stroke in children with sickle cell disease: a multicenter pediatric cohort study in French Guiana.
Observational study in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundStroke remains one of the most severe complications of sickle cell disease (SCD) in children. Although asthma is increasingly recognized as a clinical marker of SCD severity, its association with cerebrovascular complications remains insufficiently characterized. We aimed to evaluate the association between physician-documented asthma and overt stroke in children with SCD and to explore the associations of ferritin levels and continuity of care with overt stroke.
methodsWe conducted a multicenter observational cohort study including 175 children with confirmed SCD followed in three public hospitals in French Guiana between January 2012 and December 2022. Overt stroke was defined as a clinically documented neurological deficit lasting > 24 h and confirmed by brain MRI. Asthma status, ferritin levels, and continuity of care, defined as attendance at ≥ 75% of scheduled routine visits during a 12-month period, were assessed. Multivariable penalized logistic regression was used to estimate adjusted associations with overt stroke.
resultsTwenty-four children (13.7%) had a history of overt stroke. Asthma was significantly more frequent among children with stroke than among those without stroke (41.7% vs. 16.6%; unadjusted OR 3.60; 95% CI 1.44-9.02). All 175 children had complete data for the covariates included in the adjusted multivariable analysis. In multivariable analysis, asthma remained associated with higher odds of overt stroke (adjusted OR 3.05; 95% CI 1.12-8.31). Ferritin showed a non-significant trend toward higher odds of stroke (adjusted OR 1.58 per SD increase; 95% CI 0.99-2.63). Irregular continuity of care also showed a non-significant increase in the odds of stroke (adjusted OR 2.10; 95% CI 0.88-5.02). All 175 children were included in the adjusted multivariable analysis.
conclusionsPhysician-documented asthma remained associated with higher odds of overt stroke after adjustment in this multicenter pediatric SCD cohort. Ferritin levels and irregular continuity of care showed non-significant exploratory trends. These findings suggest that asthma may identify a subgroup of children with SCD requiring closer clinical assessment. Prospective studies are needed to confirm this association and clarify its clinical significance.
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