The World Health Organisation (WHO) has launched its first global guideline for managing sickle cell disease (SCD) during pregnancy, offering new hope for millions of women at risk of life-threatening complications.
This landmark publication, released on June 19, addresses a longstanding gap in maternal healthcare for women living with SCD, a group of inherited blood disorders that severely affect red blood cells and can lead to complications such as severe anemia, pain crises, stroke, and organ failure. During pregnancy, the risks increase significantly for both mother and baby.
Women with SCD are up to 11 times more likely to die from pregnancy-related causes compared to women without the condition.
They also face higher chances of experiencing serious complications such as pre-eclampsia, while their babies are at increased risk of stillbirth, low birth weight, or premature delivery.
“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).
Until now, the management of SCD in pregnancy relied heavily on clinical guidance developed in high-income countries, often out of touch with the realities faced in low- and middle-income nations—where over 80% of SCD cases occur.
Sub-Saharan Africa, in particular, carries the highest burden, accounting for eight in ten global cases.
The new WHO guideline responds directly to this gap by offering more than 20 evidence-based recommendations tailored to settings where most SCD-related maternal deaths occur.
These address everything from folic acid and iron supplementation and pain management to infection prevention, blood transfusions, and close monitoring of the mother and baby’s health.
The guideline also emphasises the importance of integrating multidisciplinary care, calling for coordinated support from haematologists, midwives, obstetricians, and paediatricians to improve outcomes.
It urges healthcare providers to offer respectful, individualised care while addressing stigma and discrimination that continue to affect people living with SCD.
“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, WHO Medical Officer and lead author of the guideline.
The WHO is also calling for increased investment in research focused on the safety and effectiveness of SCD treatments in pregnant and breastfeeding women, a group that has historically been excluded from clinical trials.
Despite the growing prevalence of SCD affecting an estimated 7.7 million people globally, the disease remains underfunded and under-researched, particularly in regions where it is most widespread.