Sickle Cell Disease & Preterm Birth: Understanding the Risks and Navigating a Healthy Pregnancy

Sickle cell disease (SCD) is an inherited condition that affects 8 million people worldwide, ¹ particularly those of African, Caribbean, Mediterranean, and South Asian descent. For pregnant individuals with SCD, the journey to motherhood can be faced with unique challenges, including an increased risk of preterm birth. This blog explores the connection between sickle cell disease and preterm birth, the risks involved, and how to manage a healthy pregnancy despite these challenges.

What is Sickle Cell Disease (SCD)?

SCD is caused by a genetic mutation in the β-globin gene, leading to the production of abnormal hemoglobin (HbS), this causes the red blood cells within a patient’s body to be “sickle-shaped”. This red blood cell shape can block blood flow causing pain and other serious health complications.¹

Pregnancy & SCD:

Pregnancy often worsens SCD symptoms due to its related physiological changes such as:
- Increased blood volume
- Hormonal shifts
- Higher metabolic demands.²
These changes can trigger:
- Vaso-occlusive crises: when sickle-shaped red blood cells block blood flow in small blood vessels leading to tissues receiving less oxygen.
- Acute chest syndrome (ACS): when sickle-shaped red blood cells block blood vessels in lungs, leading to lung tissue damage & inflammation.
- Thromboembolic events: when blood clots form in a blood vessel and breaks loose traveling to another part of the body & blocking blood flow.

How does SCD Increase the Risk of Preterm Birth?

1. Reduced blood flow due to sickle-shaped cells can block blood flow to the placenta, causing placental dysfunction.

2. Several pregnancy complications are more common with mothers who have SCD, which are contributors to preterm birth:

Preeclampsia: which consists of high blood pressure & signs of damage to organ systems (most commonly the liver & kidneys).
Placental Abruption: When the placenta partially or completely separates from the uterine wall prior to delivery. This can deprive the baby of oxygen & nutrients / cause severe bleeding in the mother.
Higher risk of Infections.

3. Chronic anemia & reduced oxygen delivery to the fetus can trigger early labour.

While sickle cell disease can make pregnancy more challenging, proper care and monitoring can help reduce risks and improve outcomes for both you and your bundle of joy! By working closely with healthcare providers and following recommended guidelines, women with SCD can navigate pregnancy with confidence and hope for a healthy future.

REFERENCES

National Heart, Lung, and Blood Institute. (n.d.). Sickle cell disease. U.S. Department of Health and Human Services. Retrieved February 6, 2024, from https://www.nhlbi.nih.gov/health/sickle-cell-disease
Shegekar, T., & Pajai, S. (2023). A Comprehensive Review of Pregnancy in Sickle Cell Disease. Cureus, 15(6), e41165. https://doi.org/10.7759/cureus.41165
National Health Service. (n.d.). Living with sickle cell disease. Retrieved February 6, 2024, from https://www.nhs.uk/conditions/sickle-cell-disease/living-with/