Studies in Sickle Cell Anemia

Abstract

EARLIER clinical observations have suggested that patients with sickle cell disease tend to show an increased incidence of complications during labor,^1,2 a tendency to lowered fertility,^3,4 characteristic hypoplastic genitalia,^5,6 eunuchoid habitus,^6-11 and are often smaller than their nonanemic siblings.^11,12 Studies previously reported by Michelson¹³ that the average age of menarche in Negroes (with a comparative study by Boas,¹⁴ Simmons and Greulich,¹⁵ on the age of menarche among white girls), was 12.94±1.1 years in the northern states and 13.68±1.4 years in the southern part of the United States. This variation in the onset in the different regions was believed to be due to a better socioeconomic status of Negroes in the north according to Michelson,¹³ Engelsman,¹⁶ and Gould and Gould.¹⁷ During the past three decades, the age of onset of puberty has decreased by ten months in Negroes and