New WHO Guide Aims to Cut Pregnancy Risks for Women with Sickle Cell Disease
GENEVA, Switzerland — The World Health Organization (WHO) has released its first global guideline focused on managing sickle cell disease (SCD) during pregnancy. The announcement, made on Thursday, marks a major step in addressing a growing health crisis that affects millions of women worldwide.
SCD, an inherited blood disorder, leads to abnormal red blood cells that block circulation and reduce oxygen flow. It causes severe pain, organ damage, infections, and life-threatening complications such as stroke or sepsis. These risks increase sharply during pregnancy, placing both mother and child in danger.
WHO warns that women with SCD are up to 11 times more likely to die during pregnancy than those without the condition. They also face higher chances of complications like pre-eclampsia, stillbirth, or premature delivery.
“There’s no reason a woman living with sickle cell disease shouldn’t experience a safe pregnancy if she receives the right care,” said Dr. Pascale Allotey. “This guideline aims to make that possible.”
Rising burden and unequal access
More than 7.7 million people globally are living with SCD — a 40% increase since 2000, according to WHO. The disease remains most common in malaria-endemic regions, with sub-Saharan Africa accounting for 80% of all cases. But as life expectancy rises and global migration continues, the condition is becoming more widespread.
SCD causes over 375,000 deaths each year, yet remains under-funded and poorly understood in many health systems. Until now, guidance for treating pregnant women with SCD has largely come from high-income countries, leaving a gap in care for the areas hit hardest by the disease.
The new WHO guideline closes that gap by providing over 20 recommendations tailored to low- and middle-income countries. These include guidelines on folic acid and iron supplementation in malaria zones, management of pain crises, infection prevention, and the safe use of blood transfusions. It also emphasizes frequent health monitoring for both mother and baby.
Call for individualized care
The guideline calls for pregnancy care to be based on each woman’s medical history and personal needs. It highlights the importance of early conversations between patients and skilled care teams — ideally before pregnancy begins.
“It’s essential that women with sickle cell disease can discuss their care options early in pregnancy—or even before,” said Dr. Doris Chou, lead author of the guideline. “This helps them prepare for any risks and decide on the best path forward.”
WHO stresses the need for experienced health professionals, including hematologists, midwives, pediatricians, and obstetrician-gynecologists, to be involved in care for pregnant women with SCD. The document also urges action against stigma and discrimination in health settings, which remains a serious barrier to care in many countries.
More research needed on treatment safety
Despite growing awareness of SCD, the WHO notes that pregnant and breastfeeding women are still widely excluded from clinical trials. As a result, there is limited data on which treatments are safe for them.
The guideline urges global investment in research and calls on countries to prioritize SCD in their maternal and newborn health strategies.
This release is the first in a broader WHO series on managing noncommunicable diseases during pregnancy. Upcoming guidelines will cover heart disease, diabetes, respiratory conditions, mental health, and substance use all increasingly recognized as leading causes of maternal and neonatal illness and death.
WHO’s message is clear: with informed care, women with sickle cell disease can have healthy pregnancies but stronger systems, more resources, and evidence-based policies must support them.
