Reproductive Health and Pregnancy Outcomes Among Women With Sickle Cell Disease in Tribal Communities of India: A Community-Based Retrospective Comparative Study.

BACKGROUND

Sickle cell disease (SCD) poses major reproductive health challenges for women. Evidence on pregnancy and maternal outcomes among women with SCD remains sparse from India. This study examined reproductive health, pregnancy-related complications, and outcomes among women with SCD compared with age- and occupation-matched controls.

METHODS

A community-based retrospective cross-sectional study was conducted among women of reproductive age in five SCD-endemic tribal areas of India. Data were collected through structured interviews covering pregnancy history, hydroxyurea use during the periconceptional-to-antenatal period, delivery, and postpartum outcomes. Of a cohort of 108 women with SCD, data of 37 ever-married women with SCD with a history of conceptions and their matched controls were used.

RESULTS

Women with SCD showed higher rates of anaemia (43% vs. 12.5%, p < 0.001), pain crises (42% vs. 11.5%, p < 0.001), and blood transfusion during pregnancy (16% vs. 1%, p < 0.001). They also had more complications during delivery, including pain, fever, and emergency caesarean sections (10% vs. 3%, p < 0.05). Postpartum complications such as pain, vaso-occlusive crises, and ICU admissions were more frequent among SCD women. Birth preparedness was notably poorer. The proportion of live births to total conceptions was slightly lower among women with SCD (82% vs. 87%) due to a higher number of abortions and stillbirths. Only 10% of women with SCD used hydroxyurea during the periconceptional-to-antenatal period.

CONCLUSION

Women with SCD in tribal settings face considerable reproductive and maternal health risks. Integrating reproductive health and antenatal services into SCD care is essential to reduce maternal and neonatal morbidity in high-burden, resource-limited regions.