Aims: This study aims to determine the influencing factors for adverse pregnancy outcomes by comparing the blood tests and pregnancy outcomes of pregnant women with different types of thalassemia minor and iron deficiency anemia.Methods: A retrospective case-control study was conducted on singleton pregnant women in our hospital from January 2019 to November 2021. Included four study groups αTT group(n=106), βTT group(n=162),TT&IDA group(n=108), IDA group(n=81). The normal pregnant women during the same period were the control group(n=546).Results: The cesarean rate of the four study groups was significantly higher than that of the control group, and the rate of fetal lung maturation in the αTT, βTT and TT&IDA groups was lower. The levels of Hb, HCT, MCV, MCH, and MCHC in the four groups were lower, while RDW was significantly higher than that in the control group. The incidence of adverse maternal outcomes in the 4 groups was lower, but the incidence of intrahepatic cholestasis of pregnancy in the αTT and βTT groups was higher than that in the control group.Conclusions: The results suggest that Mediterranean disease characteristics and IDA have an effect on some adverse maternal outcomes, but don’t increase adverse neonatal outcomes. Women with βTT had more severe anemia. Iron supplementation for pregnant women without anemia will increase the risk of gestational diabetes. It is recommended to regard the Hb level in the first 3 months of pregnancy as a high-risk factor for gestational diabetes and not recommend routine iron supplementation for women with high Hb.
Backgrounds A few studies have focused on the effect of thalassemia and different Hb levels on pregnancy outcomes recently. However, to our knowledge, there are no studies on the effects of different levels of hemoglobin(Hb) on pregnancy outcomes in Chinese women with thalassemia minor. In the present research, we aimed to clarify the effect of different Hb levels on pregnancy outcomes and to further explore the association of different Hb levels and gestational diabetes mellitus (GDM) in pregnant women with thalassemia minor in Chinese populations. Methods A retrospective controlled study was conducted on 723 pregnant women who were followed up for delivery in our hospital from 2017 to 2021. They were grouped into thalassemia minor and control group. The two groups were further divided into three subgroups, including anmia, normal and high Hb subgroups. Pregnant complications were studied in two main groups and their three subgroups. All statistical analyses were performed using R version 4.1.0 and contributed packages. Results There were no significant differences regarding neonatal and maternal pregnancy outcomes in women with and without thalassemia except for postpartum anemia. Furthermore, in the thalassemia group, the prevalence of GDM in the high Hb subgroup was significantly higher than the other two subgroups. However, in the control group, no significant statistical differences were found among the three subgroups. Moreover, in the high Hb subgroup, the fetuses of women with thalassemia were more likely to develop jaundice after birth. In the normal Hb subgroup, the proportion of macrosomia in the thalassemia group was significantly higher than the control group, while the proportion of low birth weight infants was on the contrary. Lastly, in anemia subgroups, we found less pregnant women with thalassemia suffered from cesarean compared to pregnant women without thalassemia. Conclusion We concluded that high Hb concentration might be a trigger for GDM in Chinese pregnant women with thalassemia minor. Maternal iron and Hb levels should be monitored during antenatal care and pregnancy management, as iron supplementation may lead to adverse pregnancy outcomes in women with thalassemia minor with normal or particularly high Hb concentrations.
Background: Thalassemia trait (TT) and iron deficiency anemia (IDA) are the most common conditions of microcytic hypochromic anemia (MHA) in pregnant women. Accurate discrimination between TT and IDA is an important issue, and better methods are urgently needed. Although considerable RBC formulas and indices have been developed since 1973, distinguishing between IDA and TT is still a challenging problem due to the diversity of various anemic populations. To address this problem, we assessed the diagnostic function of 43 different differential formulas in patients with microcytic anemia by using accuracy measures and recommending a new log-based differential formula.Methods: The data of 430 pregnant women (229 with TT and 201 with IDA) were enrolled, and 44 formula performances were evaluated with receiver operating characteristic (ROC) analysis.Results: The newly introduced logarithm-based formula XS-1 performs better than the general discriminant index with sensitivity and specificity of 82.10 and 89.05, which are better than other formulas. In the pregnant population, the Shine and Lal and Roth..SVM. formulas have shown excellent performance, while other formulas showed poorer discriminative abilities in our study than in the original authors.Conclusion: The logarithm-based formula XS-1 can be used to screen thalassemia and iron deficiency anemia during pregnancy. Considering the particularity of pregnancy, medical personnel in different regions should choose a screening formula similar to that of the local region and population when identifying thalassemia in pregnancy. Any formula should be independently verified locally before use. For the convenience of the health care team and experimental scientists, a web-based tool has been established at http://yyy.yiyiy.top:28992/XS-1/ by which users can easily get their desired screening test result without going through the underlying mathematical and computational details.
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