To the Editor: Sickle cell disease (SCD), the commonest genetic disease in the world, affects
multiple organ systems including the respiratory system. 1 Specifically, SCD is associated
with lung restriction, airway hyperresponsiveness, pulmonary hypertension, and acute chest
syndrome (ACS). 1 In pregnancy, a combination of hormonal changes and mechanical
effects of the enlarging uterus may result in respiratory dysfunction including rhinitis of
pregnancy, sleep-disordered breathing, and small airway closure. 2 The combined effects of …

Objective: We tested the hypothesis that impaired maternal gestational pulmonary function,
assessed by a moderate-to-severe reduction in FEV1% predicted, is associated with
adverse perinatal outcomes in women with SCD. Design: Prospective cohort study. Setting:
Tertiary referral centre Population: A total of 104 pregnancies in Ghanaian women with SCD
aged 18–41 years. Methods: Participants were categorized into two groups (FEV1%
predicted≥ 65: n= 94; FEV1% predicted< 65: n= 10) based on spirometry performed before …