A carregar...
Publicação
Translating research into practice: implementing the LEARNER SCD pregnancy study in Angola
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 12.06 MB | Adobe PDF |
Orientador(es)
Resumo(s)
Introduction: Pregnancy in Sickle Cell Disease (SCD), a severe genetic condition highly prevalent in Sub-Saharan Africa, is usually associated with an increase in severe outcomes. Not only do the common symptoms of the disease, such as severe anemia and vaso-occclusive crises, tend to exacerbate, but also the risk of eclampsia, pre-eclampsia, maternal and fetal death, intrauterine growth restrictions, and low birth weight is higher. Medical surveillance during pregnancy is essential, and also, the search for prophylactic and affordable measures is an urgent need, especially in Low- and Middle-income countries with high prevalence of this disease. The use of daily low-dose aspirin is considered safe in pregnant women with SCD and is recommended after 12 weeks of gestational age by the British Society of Haematology for those at severe risk of pre-eclampsia. The LEARNER clinical study (NCT06417411) aims to evaluate the effects of daily low-dose aspirin in SCD pregnancy, comparing its impact on severe outcomes if this prophylactic and affordable medication is started in the first or the second trimester. Methods: This study aims to recruit 450 pregnant women with a confirmed SCD diagnosis in multiple maternity and infant hospitals in Luanda, Angola. Consenting patients will be assigned to the first (weeks 6–13) or second (weeks 14–27) trimester groups according to their gestational age, as confirmed by ultrasound. Participants will start daily low-dose aspirin and will do regular follow-up appointments till 6 weeks postpartum. Aspirin will be interrupted at week 36, delivery time, or earlier if decided by the clinical team. Results: Recruitment started in March 2024, after ethical and regulatory approvals (Parecer no. 52/CEMS/2023, and 99/ARMED/MINSA/2024). In 15 months, 113 women were enrolled in the study, 57 in the first trimester and 56 in the second trimester. To date, 271 severe events, 3 associated with the medication, 9 cases of pre-eclampsia/eclampsia, 36 preterm deliveries, 5 miscarriages, 1 perinatal death, and 4 maternal deaths were registered. Conclusion: The current sample size is too small to draw statistically significant conclusions about the efficacy of starting low-dose daily aspirin earlier in pregnancy. Although the project has been promoted in hospitals and health centers through the media, in newspapers, and on television, to increase the participation in the study, the number of enrolled patients is below the expected, as most pregnant women tend to seek hospital care only during the later stages of pregnancy. It is urgent to invest in health literacy and SCD education in Angola and increase patients' awareness of the need to do prenatal and follow-up consultations during pregnancy for the prevention of pregnancy-associated complications in women with SCD.
Descrição
The present project has the support of Calouste Gulbenkian Foundation and La Caixa Foundation Collaboration (We'Search), and FCT—Fundação para a Ciência e Tecnologia, I.P. by project reference 2023.00426.BD and DOI identifier https://doi.org/10.54499/2023.00426.BD.
Palavras-chave
Sickle cell disease Pregnancy Learner SCD Angola Luanda FCT_2023.00426.BD
Contexto Educativo
Citação
Ginete C, Brito M, Gomes T, Pitangueira H, Mendes M, Furtado A, et al. Translating research into practice: implementing the LEARNER SCD pregnancy study in Angola. In: 20th Annual Sickle Cell & Thalassaemia Conference, London (UK), October 1-4, 2025. British Journal of Haematology. 2025;207 Suppl 1:S86-7.