Studies in Sickle Cell Anemia

EARLIER clinical observations have suggested that patients with sickle cell disease tend to show an increased incidence of complications during labor,1,2a tendency to lowered fertility,3,4characteristic hypoplastic genitalia,5,6eunuchoid habitus,6-11and are often smaller than their nonanemic siblings.11,12 Studies previously reported by Michelson13that the average age of menarche in Negroes (with a comparative study by Boas,14Simmons and Greulich,15on 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,13Engelsman,16and Gould and Gould.17 During the past three decades, the age of onset of puberty has decreased by ten months in Negroes and