The World Health Organization (WHO) has released the first global recommendations for managing sickle cell disease (SCD) during pregnancy, in an attempt to address a long-overlooked health concern. This milestone aims to protect the lives of women and babies who are at increased risk as a result of the illness, which affects millions throughout the world.
Sickle cell disease, an inherited blood ailment, causes red blood cells to bend into crescent shapes, resulting in extreme pain, anemia, infections, and potentially fatal complications such as strokes and organ failure. Pregnancy exacerbates these dangers, with women suffering with SCD facing a four to eleven times higher likelihood of maternal mortality compared to those without the illness.
Their pregnancies are also more likely to be marked by pre-eclampsia, stillbirth, or preterm and underweight births.
Dr. Pascale Allotey, WHO’s Director for Sexual and Reproductive Health, emphasized that with proper care, women with SCD can have healthy pregnancies. “This guideline is a crucial step toward ensuring safer outcomes,” she said, calling for urgent investment in accessible, evidence-based treatments.
The disease’s global impact is increasing, with an estimated 7.7 million people living with SCD, a 40% rise since 2000. While Sub-Saharan Africa bears the heaviest burden, accounting for 80% of cases, migration and increased life expectancy are spreading the sickle cell gene to new regions, including the Caribbean, South Asia, and portions of the Middle East.
Up until now, SCD pregnancy care procedures were mostly based on high-income nations’ approaches. The WHO’s new guidelines, designed for low- and middle-income countries, include more than 20 recommendations, including folic acid and iron fortification, infection prevention, pain management, and responsible use of blood transfusions.
A key focus is on personalized, stigma-free care, acknowledging the discrimination many SCD patients face in healthcare systems.
Dr. Doris Chou, a key author of the recommendations, emphasized the value of early consultation. “Women should have the opportunity to discuss their care options with knowledgeable providers before or early in pregnancy,” she said, arguing for multidisciplinary teams that include hematologists, obstetricians and midwives.
In spite its increasing global incidence, SCD remains underfunded and understudied, particularly in maternal health. The guideline emphasizes the urgent need for additional research on medicines for pregnant and nursing women, who are frequently excluded from clinical trials.
This publication marks the beginning of a WHO series addressing noncommunicable diseases in pregnancy, with future guidelines to cover cardiovascular conditions, diabetes, and mental health. As chronic diseases increasingly contribute to maternal mortality, these efforts aim to bridge critical gaps in care—ensuring no woman is left behind.
Source: WHO
