Ginete, CatarinaCruz, CarolinaDelgadinho, MarianaMendes, ManuelaSimão, FernandaAlves, LigiaVasconcelos, JocelyneBorralho, PaulaBrito, Miguel2026-05-272026-05-272026-07Ginete C, Cruz C, Delgadinho M, Mendes M, Simão F, Brito M, et al. Sickle cell disease: can genetic variability influence pregnancy outcomes? Blood Cells Mol Dis. 2026;119:103011.1079-9796http://hdl.handle.net/10400.21/22904This project was funded by H&TRC, IPL/IDI&CA2024/GenFalci_ESTeSL, Calouste Gulbenkian Foundation, and Camões – Instituto da Cooperação e da Língua I.P., and supported by FCT - Fundação para a Ciência e a Tecnologia, I.P. - project reference 2023.00426.BD and DOI identifier 10.54499/2023.00426.BD.Pregnancy in Sickle Cell Disease (SCD), a severe hereditary genetic condition, highly prevalent in Sub-Saharan African countries, is associated with increased risk of complications and severe outcomes in pregnancy, like intrauterine growth restriction, low birth weight, premature birth, miscarriage, stillbirth, pre-eclampsia, and maternal mortality. Several factors have been identified as associated with the heterogeneity of SCD phenotypes, namely the hemoglobin subunit beta (HBB) haplotype and −3.7 kb α-thalassemia deletion. Objective: This study aimed to identify pregnancy complications and severe outcomes, and their association with genetic variability in women with SCD. Methods: In a cohort of 162 pregnant women followed at Maternidade Lucrécia Paim, Luanda, Angola, we collected clinical, hematological, biochemical, and genetic data (Sickle Cell Disease genotype, HBB haplotype, and −3.7 kb α-thalassemia). Findings: The Central African Republic (CAR) haplotype was the most prevalent, being 87% of women homozygous. For the −3.7 kb α-gene deletion, 11.7% of women were homozygous, and 36.4% were heterozygous. In this cohort, CAR/CAR women had over 9 times higher odds of having a premature birth, and homozygous women for the −3.7 kb α-thalassemia had over four times higher odds of having a livebirth than the other genotypes. Over 50% of babies were born with low birth weight, and 52,7% were considered premature. Severe maternal complications were registered in 68% of current pregnancies. Conclusion: These findings highlight the high burden of adverse outcomes in SCD pregnancy and the need for individualized and closer healthcare, especially in low and middle-income countries.engSickle cell diseasePregnancyHBB haplotype−3.7 kb α-thalassemiaAngolaLuandaIPL/IDI&CA2024/GenFalci_ESTeSLFCT_2023.00426.BDjournal article10.1016/j.bcmd.2026.103011