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The World Health Organisation (WHO) has introduced its inaugural global guideline for managing sickle cell disease (SCD) during pregnancy.
Announced in a statement on Thursday to mark the 2025 World Sickle Cell Day, this guideline aims to address significant and escalating health challenges that can endanger both mothers and infants.
The theme for the 2025 WSCD, celebrated worldwide on June 19, is "Global Action, Local Impact: Empowering Communities for Effective Self-Advocacy." SCD refers to a collection of inherited blood disorders marked by red blood cells that take on a crescent or sickle shape.
These malformed cells can obstruct blood flow, leading to sevlere anemia, intense pain episodes, recurrent infections, and life-threatening conditions such as strokes, sepsis, or organ failure.
The health risks tied to SCD can worsen during pregnancy due to the increased demands on the body's oxygen and nutrient supply.
The WHO has indicated that women with SCD are four to eleven times more likely to experience maternal mortality compared to those without the disorder. It highlighted that these women are prone to obstetric issues such as pre-eclampsia, while their infants face a higher risk of stillbirth or being born prematurely or with low birth weight.
The organisation cited, Director of Sexual and Reproductive Health and Research, along with the United Nations Special Programme for Human Reproduction (HRP), Dr. Pascale Allotey stating that "the new guideline aims to enhance pregnancy outcomes for those affected."
Dr. Allotey emphasized that with adequate healthcare, women with disorders like sickle cell disease can achieve safe and healthy pregnancies and deliveries.
She noted the urgent need for increased investment to broaden access to evidence-based treatments during pregnancy and to improve diagnosis and understanding of this often-overlooked disease.
According to Dr. Allotey, approximately 7.7 million individuals globally are living with SCD, a figure that has grown by over 40 percent since 2000.
It is estimated that SCD leads to more than 375,000 deaths annually, primarily occurring in regions where malaria is endemic, particularly sub-Saharan Africa, which accounts for about 80 percent of cases, as well as in parts of the Middle East, the Caribbean, and South Asia.
Additionally, she pointed out that the sickle cell gene is spreading globally due to population movements and longer life expectancy, highlighting the need for more maternity care providers to understand how to manage the disease.
Dr. Allotey stated that previously, guidance for managing SCD in pregnancy was based mainly on protocols from high-income nations.
She mentioned that "WHO's new guideline aims to provide evidence-based recommendations that are applicable to low- and middle-income contexts, where most cases and fatalities from the disease occur."
The guideline includes over 20 recommendations, including the use of folic acid and iron supplements, particular adjustments for malaria-prone areas, management strategies for sickle cell crises, pain relief, prevention of infections and blood clots, as well as the use of prophylactic blood transfusions and ongoing monitoring of both the mother and baby's health throughout pregnancy.
Importantly, the guideline emphasizes the necessity for respectful, individualized care tailored to each woman's specific needs, medical history, and preferences.
It also addresses the crucial issue of diminishing stigma and discrimination in healthcare environments, which poses significant challenges for individuals with SCD in various countries.
The Medical Officer and Lead Author of the guideline, Dr. Doris Chou, underscored the importance of women with sickle cell disease discussing their treatment options with knowledgeable providers early in their pregnancy.
Dr. Chou stated, "This facilitates informed decisions regarding any treatments to pursue or adopt and establishes an agreement on managing potential complications to optimize outcomes for the woman, her pregnancy, and her infant."
She noted that due to the complexity of SCD, it is imperative to involve a skilled and knowledgeable care team, which may include specialists such as hematologists, midwives, pediatricians, and obstetrician-gynecologists focusing on reproductive and newborn health.
Dr. Chou remarked that "SCD is a neglected health condition that remains significantly underfunded and under-researched, despite its increasing prevalence worldwide.
While treatment options are improving for the wider population, the guideline highlights the urgent requirement for additional research into the safety and efficacy of SCD treatments for pregnant and breastfeeding women, who have historically been excluded from clinical trials."
According to her, this publication marks the first in a new WHO series addressing the management of non-communicable diseases during pregnancy.
She concluded, "Future guidelines will focus on cardiovascular disorders, diabetes, respiratory issues, mental health conditions, and substance use, acknowledging that chronic diseases are increasingly recognized as significant contributors to maternal and newborn mortality and poor health."
