Guidelines for managing sickle cell in pregnancy – WHO
Guidelines for managing sickle cell in pregnancy – WHO
The World Health Organisation has released its first-ever global guideline on the management of Sickle Cell Disease during pregnancy.
In a statement issued on Thursday in commemoration of the 2025 World Sickle Cell Day, the organisation said that the guideline would address critical and growing health challenges that could threaten both women and babies.
The theme of the 2025 WSCD, annually celebrated around the world on June 19, is “Global Action, Local Impact: Empowering Communities for Effective Self-Advocacy.”
SCD is a group of inherited blood disorders characterised by abnormally shaped red blood cells that resemble crescents or sickles.
The cells can block blood flow, causing severe anaemia, episodes of severe pain, recurrent infections, as well as medical emergencies like strokes, sepsis, or organ failure.
Health risks associated with SCD can aggravate during pregnancy due to heightened demands on the body’s oxygen and nutrient supply.
The global body, therefore, stated that women with SCD faced a four-to-11-fold higher likelihood of maternal death than those without the disease.
It noted that such women are likely to experience obstetric complications like pre-eclampsia, while their babies are at greater risk of stillbirth or being born early or small.
The organisation quoted Dr Pascale Allotey, the Director, Sexual and Reproductive Health and Research and United Nations Special Programme for Human Reproduction (HRP), as saying that “the new guideline is to improve pregnancy outcomes for those affected.
“With quality health care, women with inherited blood disorders like Sickle Cell Disease can have safe and healthy pregnancies and births.
“With sickle cell on the rise, more investment is urgently needed to expand access to evidence-based treatments during pregnancy, as well as diagnosis and information about this neglected disease.”
According to Allotey, around 7.7 million people are living with SCD worldwide, a figure that has increased by more than 40 per cent since 2000.
“SCD is estimated to cause more than 375,000 deaths each year. The disease is most prevalent in malaria-endemic regions, particularly sub-Saharan Africa, which accounts for around eight in 10 cases, as well as parts of the Middle East, the Caribbean and South Asia,” Allotey said.
She added that the sickle cell gene is becoming widespread globally due to population movements and improvements in life expectancy, meaning more maternity care providers need to know how to manage the disease.
Allotey said that until now, clinical guidance for managing SCD in pregnancy was largely drawn from protocols in high-income countries.
She added, “WHO’s new guideline aims to provide evidence-based recommendations that are also relevant for low – and middle-income settings, where most cases and deaths from the disease occur.
“Accordingly, the guideline includes more than 20 recommendations spanning: folic acid and iron supplements, including adjustments for malaria-endemic areas, management of sickle cell crises and pain relief and prevention of infections and blood clots.
“Others are the use of prophylactic blood transfusions and additional monitoring of the woman and the baby’s health throughout pregnancy.”
Critically, the guideline highlights the need for respectful, individualised care, adapted according to women’s unique needs, medical histories, and preferences, she added.
She said it also addresses the importance of tackling stigma and discrimination within healthcare settings, which can be a major challenge for people with SCD in several countries around the world.
The Medical Officer and Lead Author of the guideline, Dr Doris Chou, said it is essential that women with sickle cell disease discuss their care options early in pregnancy with knowledgeable providers.
Chou said, “This supports informed decisions about any treatment options to continue or adopt, as well as agree on ways of handling potential complications, so as to optimise outcomes for the woman, her pregnancy and her baby.”
She explained that given the complex nature of SCD, there is a need to involve skilled and knowledgeable personnel in the care team of women living with the disorder.
This may include specialists like haematologists, midwives, paediatricians, and obstetrician-gynaecologists who provide services for reproductive and newborn health.
“SCD is a neglected health condition that remains considerably under-funded and under-researched, despite its growing prevalence worldwide.
“While treatment options are improving for the general population, the guideline underscores the urgent need for more research into the safety and efficacy of SCD treatment for pregnant and breastfeeding women that have historically been excluded from clinical trials,” she said.
According to her, the publication is the first in a new WHO series on managing non-communicable diseases in pregnancy.
“Future guidelines will address cardiovascular conditions, diabetes, respiratory diseases, mental health disorders, and substance use.
“This is because chronic diseases are increasingly recognised as major contributors to maternal and newborn deaths and ill health,” she said.
NAN
