Sickle Cell Anaemia in Pregnancy: A Critical Appraisal of Burden, Challenges, and Management Dilemmas in Nigeria

Abstract

Background: Sickle Cell Anaemia (SCA) is one of the most prevalent genetic disorders in Nigeria and poses significant risks during pregnancy. Women with SCA are at elevated risk of maternal complications such as vaso-occlusive crises, hypertensive disorders, anaemia, and increased mortality. Fetal complications include intrauterine growth restriction, preterm birth, low birth weight, and perinatal death. These risks are compounded by systemic healthcare challenges, limited access to specialized care, and sociocultural barriers. This paper appraised the burden, challenges, and management dilemmas of SCA in pregnancy in Nigeria, while highlighting best practices and recommending strategies to improve maternal and fetal outcomes.
Methods: A comprehensive review of peer-reviewed literature, clinical guidelines, and national health reports was conducted. Databases searched included PubMed, ScienceDirect, ResearchGate, and Google Scholar, covering publications from 2012 to 2025. Keywords such as "Sickle Cell Anaemia," "pregnancy," "maternal health," "Nigeria," and "management" were used with Boolean operators to identify relevant studies in English focused on the Nigerian context.
Conclusion: Nigeria bears a heavy burden of SCA in pregnancy, characterized by poor maternal and fetal outcomes due to inadequate health system responses and limited awareness. Despite existing best practices, implementation gaps persist in areas such as early diagnosis, antenatal care, transfusion safety, and pharmacologic management. To improve outcomes, Nigeria must strengthen its healthcare infrastructure, integrate SCA management into maternal health programs, increase public
awareness, and promote context-specific research. Multisectoral collaboration and policy commitment are critical to addressingthis persistent maternal health challenge.