SCD is a group of inherited blood disorders characterized by abnormally shaped red blood cells that resemble crescents or sickles. These cells can block blood flow, causing severe anaemia, episodes of severe pain, recurrent infections, as well as medical emergencies like strokes, sepsis or organ failures.
“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 and the United Nations’ Special Programme for Human Reproduction (HRP). “This new guideline aims to improve pregnancy outcomes for those affected. 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.”
Until now, clinical guidance for managing SCD in pregnancy has largely drawn on protocols from high-income countries. 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 over 20 recommendations spanning:
folic acid and iron supplementation, including adjustments for malaria-endemic areas;management of sickle cell crises and pain relief;prevention of infections and blood clots;use of prophylactic blood transfusions; andadditional monitoring of the woman and the baby’s health 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. “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 optimize outcomes for the woman, her pregnancy, and her baby.”
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 treatments for pregnant and breastfeeding women – populations that have historically been excluded from clinical trials.
This publication is the first in a new WHO series on managing noncommunicable diseases in pregnancy. Future guidelines will address cardiovascular conditions, diabetes, respiratory diseases, mental health disorders and substance use. Chronic diseases are increasingly recognized as major contributors to maternal and newborn deaths and ill health.
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