SICKLE CELL & PREGNANCY
What You Need to Know
Before having a baby, a woman and her partner should get tested for sickle and
other abnormal hemoglobin. This information is important because children
born into the family may be at risk for a disease that causes severe pain and many
health complications. Many couples can be carriers for sickle cell trait and give birth
to children with sickle cell disease (SCD).
About 1 in 12 Black or African-American babies is born with sickle cell trait.
About 1 in 100 Hispanic American babies is born with sickle cell trait.
SCD occurs in about 1 out of every 365 Black or African-American births.
SCD occurs in about 1 in out of every 16,300 Hispanic-American births.
If you're already pregnant, prenatal testing is available after the second month of pregnancy. Providers can perform an amniocentesis test and a chorionic villus sampling test to determine genetic disorders. The test results tell you whether the baby
is a carrier for sickle cell trait, has sickle cell disease, or other abnormal hemoglobin.
Women with sickle cell disease are considered to have high-risk pregnancies and need close monitoring by their health care providers. During pregnancy, they are likely to have complications, which can affect their health or the health of their unborn baby. Women with sickle cell trait normally have a healthy pregnancy and should be monitored by a health care provider for complications associated with pregnancy.
Children and persons with sickle cell disease (SCD) start to have signs of the disease during the first year of life, usually around 5 months of age. Early symptoms of SCD may include jaundice, fatigue, and painful swelling of the hands and feet.
In persons with SCD, there is a problem with the hemoglobin, which causes a shortage of oxygen throughout the body. This lack of oxygen can cause severe pain, anemia ( a lack of iron), infection, and organ damage; including enlargement of the spleen. Blood transfusions are used to treat severe anemia.
Children and persons who have sickle cell trait do not have sickle cell disease, nor will the trait change into the disease. Sickle cell trait typically does not cause any health problems however, under certain conditions sickling may occur. These conditions include significant hypoxia (a severe shortage of oxygen at high altitudes), dehydration, and physical exertion.
If one parent is normal (AA), and one has sickle cell trait (AS), there is a 50% chance the child will be normal and there is a 50% chance the child will have sickle cell trait.
If both parents have sickle cell trait (AS), there is a 25% chance the child will be normal (AA); there is a 50% chance the child will have sickle cell trait (AS); and a 25% chance for sickle cell anemia (SS).
If one parent has sickle cell trait (AS) and one has hemoglobin C trait (AC), there is a 25% chance the child will be normal (AA); a 25% chance the child will have sickle cell trait (AS); a 25% chance for hemoglobin C trait (AC), and a 25% chance the child will have sickle cell hemoglobin C disease (SC disease).
If one parent has sickle cell trait (AS) and one has beta-thalassemia trait (AβTHAL), there is a 25% chance the child will be normal (AA); a 25% chance the child will have sickle cell trait (AS); a 25% chance the child will have beta thalassemia trait (AβThal); and a 25% chance of sickle cell beta thalassemia disease (SβThal).
What do I do now?
Get yourself and your family tested to see if you carry the trait for abnormal hemoglobin. If you take the test, ask your provider to perform hemoglobin electrophoresis for accurate results. See your provider or call the Foundation for genetic counseling about your test results. This provides you with the facts to make an informed decision about having children.