Nairobi: The World Health Organisation (WHO) has released its inaugural global guideline on managing sickle cell disease (SCD) during pregnancy. The guidelines aim to tackle critical health challenges that pose life-threatening risks for both women with SCD and their babies.
According to Kenya News Agency, SCD is a group of inherited blood disorders with crescent-shaped red blood cells that obstruct blood flow, leading to severe anaemia, intense pain episodes, and recurrent infections. These risks are heightened during pregnancy due to increased demands on the body's oxygen and nutrient supply. Women with SCD face a significantly higher risk of maternal death and obstetric complications, while their babies are more susceptible to stillbirth or being born prematurely or underweight.
In Kenya, the impact of SCD during pregnancy is considerable, with research by the National Institutes of Health (NIH) estimating that 14,000 children are born annually with SCD. This contributes to both child and adult morbidity and mortality. Dr. Pascale Allotey from WHO emphasized that quality healthcare can enable women with SCD to have safe pregnancies and births. The guideline calls for increased investment in evidence-based treatments during pregnancy and greater dissemination of information about SCD.
Globally, approximately 7.7 million people live with SCD, a number that has risen by over 40 percent since 2000. SCD is responsible for over 375,000 deaths annually, with the highest prevalence in malaria-endemic areas like sub-Saharan Africa, which accounts for about 80% of cases, as well as parts of the Middle East, Caribbean, and South Asia. The spread of the sickle cell gene worldwide necessitates that more maternity care providers understand how to manage the disease.
Until now, clinical guidance for SCD in pregnancy largely relied on protocols from high-income countries. WHO's guideline provides over 20 evidence-based recommendations relevant to low- and middle-income settings, where most cases and deaths occur. Dr. Doris Chou, lead author of the guideline, stresses that women with SCD should discuss care options early in pregnancy with knowledgeable providers to make informed decisions about treatment and managing potential complications.
SCD remains a neglected health condition with insufficient funding and research, despite its growing prevalence. The guideline highlights the urgent need for more research into the safety and efficacy of SCD treatments for pregnant and breastfeeding women, who have often been excluded from clinical trials.