Sickle cell disease and pregnancy

Professor Guillermina Girardi, Dr Eugene Oteng-Ntim, Mr Jo Pombo

Sickle cell disease is a serious inherited illness and can lead to pregnancy complications. We want to find out why.

Sickle cell disease is a serious inherited disease that affects our red blood cells. It is the most common inherited condition in the world, and over 300,000 children are born with it every year. In the UK there are between 12,000 and 15,000 people suffering from sickle cell disease, and between 100 and 200 pregnancies every year in women who have it.

People who suffer from sickle cell have red blood cells that become rigid and elongated. They also contain an unusual form of haemoglobin, the protein that carries oxygen. This makes it hard for the cells to transport oxygen around the body. Because of their shape, the cells can block small blood vessels, which can harm tissues and organs. Finally, these abnormal blood cells aren’t replaced as quickly as normal blood cells. This means the body doesn’t have enough red blood cells: a condition called anaemia.

Pregnant women with sickle cell disease have a higher risk of miscarriage, premature birth and pre-eclampsia. We want to find out why. At the moment, we think that blood clotting and inflammation might be part of the reason.

So far, we have taken blood and placenta samples from 4 women with sickle cell disease. Scientists will study these to see how clotting and inflammation might play a role in pregnancy complications in women with sickle cell.

Meanwhile, we are also studying sickle cell mice – these share all the main features of human sickle cell disease. Researchers found that sickle cell mice gave birth to smaller litters than healthy mice, suggesting that something was going wrong during pregnancy. Newborns also suffered from growth restriction: they had not been able to grow to their full size in the womb.

This research is ongoing and hopes to find answers to how sickle cell disease affects pregnancy. This will help us to focus research into preventing premature birth, stillbirth and other complications caused by sickle cell disease that could harm the baby. 

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This study is fully funded by Tommy's and takes place in a Tommy's centre

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