A new study comparing the developmental outcomes of children born to women with sickle cell disease (SCD) with those of matched controls found the exposed children to be at higher risk of developing attention-deficit/hyperactivity disorder (ADHD) and obesity.

The study, published in eJHaem, used data from the Boston Birth Cohort (BBC), a prospective birth cohort established in 1998.

“Children exposed to maternal sickle cell disease (SCD) have many theoretical risks for developmental disorders, but little is known about long-term outcomes for these children,” the authors wrote.

The purpose of the BBC is to assess preconception and prenatal determinants of preterm birth. Of 5972 mothers in the BBC, 40 mothers with SCD and their children without SCD (mother-child dyads) and 120 controls were included in the analysis. Given that SCD is an independent risk factor for neurodevelopmental disorders (NDD), dyads in which the child also had SCD were excluded.

Read more about SCD complications

The overall prevalence of NDD in the studied group was 44%, which was significantly higher than the norm. Children exposed to maternal SCD were more likely to develop ADHD and obesity than the children of controls.

The mechanisms underlying the development of these two conditions in the context of SCD are unclear, and the authors recommend larger cohort studies in the future to elucidate these aspects. They speculate that SCD alters the uterine environment and leads to exposure of the fetus to certain pain medications, thus affecting neural development.

External influences on the child are also possible; for example, having a mother with a chronic disease could affect a child’s social and emotional development.

Reference

Brucato M, Lance E, Lanzkron S, Wang X, Pecker LH. Developmental disorders in children born to women with sickle cell disease: a report from the Boston Birth Cohort. eJHaem. Published online June 8, 2022. doi.10.1002/jha2.478