WHO Releases Guidelines for Managing Sickle Cell Disease During Pregnancy

The World Health Organization has unveiled its first-ever global guideline for managing Sickle Cell Disease during pregnancy.

In a statement released on Thursday to mark the 2025 World Sickle Cell Day, the organisation noted that the guideline aims to tackle significant and increasing health risks that could endanger both expectant mothers and their babies.

The 2025 World Sickle Cell Day, observed globally each year on June 19, is themed: “Global Action, Local Impact: Empowering Communities for Effective Self-Advocacy.”

Sickle Cell Disease, or SCD, refers to a collection of inherited blood disorders where red blood cells take on abnormal shapes resembling crescents or sickles.

These misshapen cells can obstruct blood flow, leading to severe anaemia, intense pain episodes, frequent infections, and life-threatening complications such as strokes, sepsis, or organ failure.

During pregnancy, the health complications tied to SCD may worsen due to increased physical demands for oxygen and nutrients.

As a result, the global health organisation stated that women living with SCD are “four-to-11-fold” more likely to experience maternal death compared to those without the condition.

The organization highlighted that women with inherited blood disorders, such as Sickle Cell Disease (SCD), are at higher risk of obstetric complications like pre-eclampsia, and their babies face increased chances of stillbirth, preterm birth, or low birth weight.

Quoting Dr. Pascale Allotey, Director of Sexual and Reproductive Health and Research and the United Nations Special Programme for Human Reproduction (HRP), the organization stated, “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.”

Allotey noted that approximately 7.7 million people worldwide live with SCD, a number that has risen by over 40 percent 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 further explained that the sickle cell gene is spreading globally due to population migration and increased life expectancy, requiring more maternity care providers to be equipped to manage the condition.

Allotey mentioned that, until recently, clinical guidance for managing SCD during pregnancy has primarily been based on protocols from 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.”

The guideline places strong emphasis on the importance of providing respectful, personalised care tailored to each woman’s specific needs, medical background, and preferences, she noted.

She further stated that the guideline also emphasises the need to combat stigma and discrimination in healthcare environments, which remain significant obstacles for individuals with Sickle Cell Disease in many parts of the world.

Dr. Doris Chou, Medical Officer and Lead Author of the guideline, highlighted the importance of early discussions between women with sickle cell disease and experienced healthcare providers regarding their care options during pregnancy.

Chou stated, “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 added that because of the complex nature of SCD, it is vital to include skilled and knowledgeable professionals in the care team supporting women living with the condition.

These professionals may include haematologists, midwives, paediatricians, and obstetrician-gynaecologists who specialise in 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.

She noted that this release marks the first installment in a new series of WHO guidelines focused on managing non-communicable diseases during pregnancy.

“Future guidelines will address cardiovascular conditions, diabetes, respiratory diseases, mental health disorders, and substance use.”