On 19 June, the World Health Organization (WHO) released its first-ever global guideline on the management of sickle cell disease (SCD) during pregnancy, addressing a critical and growing health challenge that can have life-threatening consequences for both women and babies.

Pregnancy significantly increases health risks for women with SCD. They face a 4- to 11-fold higher risk of maternal death compared to those without the condition, and are more likely to experience complications such as pre-eclampsia. Babies also face higher chances of stillbirth, prematurity, or low birth weight.

Until now, most guidance on this issue has been based on practices from high-income countries. WHO’s new recommendations aim to support healthcare providers worldwide, particularly in low- and middle-income countries where the disease is most prevalent.

The guideline includes over 20 key recommendations, covering:

• folic acid and iron supplementation (with adjustments for malaria-affected regions),
• management of pain and sickle cell crises,
• prevention of infections and blood clots,
• use of preventive blood transfusions,
• regular monitoring of both mother and baby.

Importantly, WHO stresses the need for respectful, personalised care, adapted to each woman’s needs, history, and preferences. It also calls for action against stigma and discrimination in healthcare settings, which often affect people with SCD.

Given the complexity of SCD, WHO highlights the importance of a multidisciplinary care team, including haematologists, paediatricians, and obstetrician-gynaecologists trained in maternal and newborn health.