The World Health Organization has released its first global guideline for managing sickle cell disease (SCD) during pregnancy, addressing a health challenge affecting 7.7 million people worldwide. The guidance targets improved outcomes for pregnant women facing 4- to 11-fold higher maternal death rates compared to those without the inherited blood disorder.
SCD causes abnormally shaped red blood cells that block blood flow, leading to severe anemia, pain episodes, and medical emergencies. Health risks intensify during pregnancy, with women experiencing higher rates of pre-eclampsia and babies facing greater risks of stillbirth or premature birth.
“With quality health care, women with inherited blood disorders like sickle cell disease can have safe and healthy pregnancies and births,” said Dr. Pascale Allotey, Director for Sexual and Reproductive Health and Research at WHO.
The global SCD population has increased by over 40% since 2000, causing an estimated 375,000 deaths annually. The disease predominantly affects sub-Saharan Africa, which accounts for approximately 80% of cases, along with parts of the Middle East, Caribbean, and South Asia.
WHO’s guideline provides evidence-based recommendations for low- and middle-income settings where most cases occur. The guidance includes over 20 recommendations covering folic acid supplementation, crisis management, infection prevention, blood transfusions, and enhanced monitoring throughout pregnancy.
“It’s essential that women with sickle cell disease can discuss their care options early in pregnancy—or ideally before—with knowledgeable providers,” said Dr. Doris Chou, Medical Officer and lead author of the guideline.
The guideline emphasizes individualized care while addressing stigma and discrimination within healthcare settings. It recommends involving skilled personnel including hematologists, midwives, and obstetricians in care teams.
WHO notes that SCD remains under-funded and under-researched despite growing prevalence. The guideline highlights urgent needs for research into treatment safety for pregnant women, who are historically excluded from clinical trials.
This publication initiates a WHO series on managing chronic diseases during pregnancy, with future guidelines planned for cardiovascular conditions, diabetes, and mental health disorders.
link