Sickle cell disease is one of the notorious inherited blood disorders, with the abnormal hemoglobin shapes creating abnormal blood cells that can create clots and cause problems in just about every organ system - so it should surprise no one that this hold true in pregnancy.
Published just in June 2025, the below article looked retrospectively at Medicaid patients in California, Georgia, Tennessee, and Michigan from 2010-2018. In total, this study included 1286 patients, 90% of whom were Black. They followed ~800 of these patients for a year postpartum to look for the most common complications.
Aside from vaso-occlusive crisis being extremely common (~40% of patients experienced at least one crisis during or in the year after pregnancy), ~25% of patients with sickle cell had antepartum hemorrhage and preterm delivery, while ~10% had preeclampsia or eclampsia.
Keep in mind that this is a retrospective cohort study that did not have any comparisons, so this is really just observational data. While we can't draw any conclusions about just how much more dangerous sickle cell disease makes pregnancy, I think the numbers are concerning enough that we should keep an even closer eye than normal on our patients who have concurrent sickle cell and pregnancy.
References
Kayle M, Zhou M, Attell BK, et al. Pregnancy- and Disease-Related Morbidity Among Medicaid Enrollees With Sickle Cell Disease. Pediatr Blood Cancer. 2025;72(9):e31857. doi:10.1002/pbc.31857
