In this MD Newsline exclusive interview with hematologist/oncologist Dr. Cheryl Mensah, we discuss how sickle cell disease can affect cognition, reproductive health, and pregnancy.
MD Newsline:
How can sickle cell disease affect cognition?
Dr. Cheryl Mensah:
“Because sickle cell disease can block blood vessels and reduce oxygen to the brain, it can result in ischemic strokes that affect cognition. And in patients with sickle cell disease, these strokes are often silent strokes, where the patient has had a stroke but is still able to walk and talk. So, you wouldn’t know they had had a stroke unless you scan their brain.
In children, we see silent strokes a lot, which may manifest as behavioral issues and poor performance at school. But, often, it’s not clear why these cognitive issues are occurring until a brain scan is done and shows evidence of a stroke.
And we even see some of these same signs in adults who experience multiple silent strokes and, as a result, have difficulty pursuing higher education or performing well at work.
So, the cognitive complications of sickle cell disease really are insidious.”
MD Newsline:
How can sickle cell disease affect reproductive health and pregnancy?
Dr. Cheryl Mensah:
“Sickle cell disease can make pregnancies more complicated. Patients with sickle cell disease may experience more pain crises, ER visits, and hospitalizations when they’re pregnant. And their babies can experience ischemia from receiving less healthy red blood cells.
Moreover, pregnant patients with sickle cell disease experience higher rates of pregnancy complications like preeclampsia, intrauterine growth restriction, and pre-term labor. Almost every complication of pregnancy is more common in patients with sickle cell disease.
So, it’s very important that pregnant patients with sickle cell disease see a hematologist and a high-risk obstetrician during their pregnancy. And patients with sickle cell disease who are considering becoming pregnant should undergo screening tests and patient counseling to ensure they’re in the best shape before they become pregnant.”
Responses have been condensed and lightly edited.
