Published in PLOS One on 2026-07-13, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. HealthSignal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Kenneth Finlayson, Gill Moncrieff, Cath Harris, Soo Downe
Source: PLOS One • DOI 10.1371/journal.pone.0352992
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Sickle Cell Disease (SCD) is one of the most prevalent genetic diseases in the world. For women with SCD or those with Sickle Cell Trait (SCT) reproductive choices not only require consideration of genetic inheritance but also the exacerbation of pregnancy induced SCD symptoms and potential birth complications. To explore these issues a qualitative synthesis was conducted incorporating the views of women with SCD or SCT as well as healthcare professionals working with these women in maternity settings.
Database searches were performed in MEDLINE, Embase, MIDIRS, CINAHL Ultimate, PsycINFO, Social Sciences Citation Index, Global Index Medicus and CNKI, as well as reference lists of included studies published January 2000–October 2024. Studies reporting qualitative data from women with SCD or SCT and health professionals providing care to these women during the maternity phase were included.
Author findings were extracted, coded and synthesised using techniques derived from thematic synthesis. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting findings was assessed using GRADE-CERQual.
Eleven studies from four different countries (UK, Brazil, France and Uganda) were identified including eight focusing on the views of women, two reporting on the views of health professionals and one exploring both. From these four analytical themes were generated: Beyond the routine of antenatal screening; Myths, misunderstandings and submissiveness; Fear and uncertainty in the face of adversity; The importance of familial and organizational support. Confidence in the results was moderate to good.
The synthesis suggests that the intersection of SCD and maternity care is beset with a lack of understanding and inadequate health system support. In some contexts, women endure stigmatization, discrimination and poor quality care. Public awareness campaigns and educational initiatives, particularly amongst healthcare professionals, are urgently required to address these issues.
Introduction
Sickle cell disease (SCD) is an umbrella term that incorporates several inherited diseases (including sickle cell anaemia (SCA), HbSC and HbSβ-thalassaemia) characterized by genetic mutations affecting the haemoglobin molecule [1]. As a consequence of these mutations red blood cells develop a characteristic sickle shape which can cause blockages in the blood vessels of people with SCD. These blockages may lead to recurrent and painful crises as well as organ and/or tissue damage [2]. SCD is also associated with severe anaemia, cerebrovascular disease, and premature mortality [3]. In addition, many infectious diseases, such as pneumococcal disease, are more dangerous to people with SCD [4] and its impact on quality of life can lead to a higher incidence of depression [5].
Recent reports suggest there are approximately 6.4 million people living with SCD globally, and from 2010 to 2050, the number of children born with SCD is expected to increase by around 30% [6]. Although SCD is more prevalent in Sub-Saharan Africa, the Middle East and parts of Southern Asia, regular waves of migration from these regions have led to an increased incidence of the condition in North America and Western Europe [7]. Over the last several decades the prognosis for people born with SCD has improved, particularly in High-Income Countries (HICs) where comprehensive screening programmes, effective treatments, specialist services and better management of the condition has extended life expectancy [8,9]. However, in many Low and Middle-Income Countries (LMICs) the impact of SCD is stark with up to 90% of infants born with the condition dying before they reach the age of five [10].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Kenneth Finlayson, Gill Moncrieff, Cath Harris, Soo Downe. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by HealthSignal. The researchers are the authors of the source study, not members of HealthSignal’s staff.
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- Evidence brief: “Heartbreak and Frustration’’ experiences of healthcare providers caring for pregnant women with sickle cell disease in Uganda
- Evidence brief: Prevalence and factors associated with microvascular and macrovascular diabetes complications in adult Ugandans: A systematic review and meta-analysis
- Evidence brief: Outcomes of hyperglycaemia in pregnancy in Africa: Systematic review and meta-analysis
