…New recommendations aim to reduce life-threatening risks for mothers and babies
By Bunmi Yekini
Geneva, 19 June 2025 — The World Health Organization (WHO) today released its first-ever global guideline for managing sickle cell disease (SCD) during pregnancy, marking a major step toward improving outcomes for women and newborns affected by the often-overlooked condition.
SCD, a group of inherited blood disorders, can cause severe anemia, pain episodes, infections, and even organ failure. During pregnancy, these risks are significantly heightened. Women with SCD are up to 11 times more likely to die from pregnancy-related complications, and their babies face higher chances of stillbirth, prematurity, or low birth weight.
“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, WHO Director for Sexual and Reproductive Health and Research. “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.”
The WHO estimates that 7.7 million people live with SCD globally, a number that has surged by over 40% since 2000. The disease is most prevalent in sub-Saharan Africa, which accounts for 80% of all cases, but increasing global migration and better life expectancy have contributed to wider geographic spread.
Until now, clinical approaches to SCD in pregnancy have mostly been based on high-income country models. WHO’s new guideline includes more than 20 evidence-based recommendations, tailored for use in low- and middle-income settings. These include folic acid and iron supplementation (with adjustments for malaria-endemic regions), pain and infection management, blood transfusion protocols, and close monitoring of mother and baby.
Dr Doris Chou, WHO Medical Officer and lead author of the guideline, emphasized the importance of early and informed care. “It’s essential that women with sickle cell disease can discuss their care options early in pregnancy, or ideally before, with knowledgeable providers,” she said. “This supports informed decisions about any treatment options to continue or adopt, as well as agree on ways of handling potential complications.”
The guideline also calls for an end to stigma and discrimination in healthcare settings, advocating for respectful, individualized care tailored to each woman’s medical history and preferences. It recommends building multidisciplinary care teams that include haematologists, obstetricians, midwives, and paediatricians.
This release is the first in a planned WHO series addressing the management of noncommunicable diseases during pregnancy. Future guidelines will focus on conditions such as cardiovascular disease, diabetes, mental health, and substance use.
Despite its growing prevalence, SCD remains severely underfunded and under-researched, especially for pregnant and breastfeeding women, who are often excluded from clinical studies. WHO stressed the urgent need for greater investment to close these critical gaps.
“With this guideline, we are acknowledging that women with sickle cell disease deserve focused, evidence-based care, and that their lives, and their babies’ lives, matter on the global health agenda,” Dr Allotey said.