The World Health Organization (WHO) has unveiled new, evidence-based guidelines aimed at the management of sickle cell disease (SCD) in pregnant women, addressing a significant gap in maternal healthcare. These guidelines highlight the intricate relationship between SCD and pregnancy, suggesting that specialized care for this population is essential.

With approximately 7.74 million people globally living with SCD, the condition often results in severe complications, including anemia, opportunistic infections, and premature mortality. Through these guidelines, the WHO seeks to enhance healthcare delivery for affected women, particularly in regions where SCD prevalence is high.

Previously, only five global guidelines touched on the subject of managing SCD during pregnancy. The WHO guidelines are a pioneering set of recommendations that offer comprehensive strategies designed for a variety of healthcare contexts, particularly benefiting low- and middle-income countries (LMICs) where SCD is more widespread.

Developed from a thorough review of scientific literature, these guidelines aim to guide policymakers and healthcare professionals in delivering effective, evidence-supported care for pregnant women with SCD. Addressing eight critical questions, the guidelines focus on minimizing health burdens while optimizing intervention outcomes based on efficacy, safety, feasibility, and cost-effectiveness.

The guideline development group (GDG) formulated 20 specific recommendations regarding the management of SCD during pregnancy. Key areas of focus include:

• Use of dietary supplements, medications, and prophylactic blood transfusions for treatment.
• Fluid management and pain control strategies, employing nonsteroidal anti-inflammatory drugs and the judicious use of opioids.
• Implementation of thromboprophylaxis in pregnant SCD patients presenting additional risk factors for thromboembolism.
• Monitoring of fetal health and careful planning of delivery methods and timing.

Importantly, iron supplementation is only advised when there is clear evidence of iron deficiency.

The guidelines also underscore the unique challenges faced by women with SCD throughout their reproductive journeys. This focus is especially critical for women residing in LMICs, where maternal mortality rates remain alarmingly high. WHO has encouraged existing guidance to ensure a positive pregnancy experience.

The introduction of these recommendations aims to provide vital support for healthcare providers, thereby improving maternal and infant health outcomes. By endorsing a consensus-driven approach to evidence-based policy implementation, the guidelines advocate for the enhanced management of SCD.

Moreover, the WHO calls for further research to address existing evidence gaps regarding the management of pregnant women with SCD, which may lead to future guidance based on stronger data.