Pregnancy in patients with β-thalassemia intermedia: Outcome of mothers and newborns

Nassar, Anwar H.; Rechdan, Johnny B.; Usta, Ihab M.; Taher, Alì

doi:10.1016/j.ajog.2004.10.225

Cited by 10 publications

(19 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16,17 Further studies are needed to clarify whether this difference could be due to the different sample size in our study compared with other studies, or whether more complex factors are involved.…”

Section: Discussionmentioning

confidence: 50%

“…[12][13][14][15] Moreover, only a few studies have been published describing pregnancy in women with thalassemia intermedia. 16 There are reports of increased risk of abortion, pre-term delivery, intrauterine growth restriction and thromboembolism in pregnant women with thalassemia intermedia. 16,17 The aim of this study was to investigate the methods of conception and delivery, as well as the course and outcome of pregnancy including transfusions, iron overload and chelation in a large population of Italian women with thalassemia major and thalassemia intermedia.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy and -thalassemia: an Italian multicenter experience

Origa¹,

Piga²,

Quarta³

et al. 2009

Haematologica

105

141

View full text Add to dashboard Cite

BackgroundRecent advances in the management of thalassemia have significantly improved life expectancy and quality of life of patients with this hemoglobinopathy, with a consequent increase in their reproductive potential and desire to have children. Design and MethodsWe describe the methods of conception and delivery, as well as the course and outcome of pregnancy including transfusions, iron overload and chelation in 46 women with thalassemia major (58 pregnancies) and in 11 women with thalassemia intermedia (17 pregnancies). Conception was achieved after gonadotrophin-induced ovulation in 33 of the women with thalassemia major and spontaneously in all of those with thalassemia intermedia. ResultsAmong the women with thalassemia major, 91% of the pregnancies resulted in successful delivery of 45 singleton live-born neonates, five sets of twins and one set of triplets. No secondary complications of iron overload developed or worsened during pregnancy. When considering only the singleton pregnancies, the proportion of babies with intrauterine growth retardation did not differ from that reported in the general Italian population. The high prevalence of pre-term births (32.7%) was mostly related to multiple pregnancies and precautionary reasons. Pregnancy was safe in most women with thalassemia major or intermedia. However, women with thalassemia intermedia who had never previously been transfused or who had received only minimal transfusion therapy were at risk of severe alloimmune anemia if blood transfusions were required during pregnancy. ConclusionsProvided that a multidisciplinary team is available, pregnancy is possible, safe and usually has a favorable outcome in patients with thalassemia. In women with hypogonadotropic hypogonadism, gonadal function is usually intact and fertility is usually retrievable.Key words: pregnancy, thalassemia major, thalassemia intermedia, hypogonadism, assisted reproduction.Citation: Origa R, Piga A, Quarta G, Forni GL, Longo F, Melpignano A, and Galanello R. Pregnancy and β-thalassemia: an Italian multicenter experience. Haematologica. 2010; 95:376-381. doi:10.3324/haematol.2009 This is an open-access paper.Pregnancy and β β-thalassemia: an Italian multicenter experience

show abstract

Section: Discussionmentioning

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Pregnancy and -thalassemia: an Italian multicenter experience

Origa¹,

Piga²,

Quarta³

et al. 2009

Haematologica

105

141

View full text Add to dashboard Cite

show abstract

“…Pregnancy is an example of a factor that may lead to a patient with thalassaemia intermedia requiring blood transfusion support. A review of the outcomes of pregnant patients with thalassaemia intermedia showed a high degree of complications (Nassar et al, ). This includes fetal death in 20–33% (Voskaridou et al, ).…”

Section: Case 4 – Haemoglobinopathy Diagnosismentioning

confidence: 99%

The management of anaemia and haematinic deficiencies in pregnancy and post‐partum

Roy

Pavord

2018

Transfusion Medicine

View full text Add to dashboard Cite

Anaemia is one of the most common disorders in the world (24·8% of the world population) (de Benoist 2008) and affects patients of all ages and ethnic origins. Underlying causes and prevalences vary by age group and socioeconomic background, but pregnant women everywhere are at high risk of anaemia, the vast majority of cases being due to iron deficiency. One in four pregnant women in Europe are thought to have iron deficiency anaemia (Daru et al., March 2016), whereas in parts of Africa, where hookworm infestation is common, this has been estimated to be as high as 38% (Stevens et al., 2013) to 50% (Bah et al., June 2017). Women of menstruating age are rarely iron replete (Low et al., 18 April 2016) and then enter pregnancy, which carries a major negative iron balance (Bentley, October 1985). Despite a good understanding of the causes of anaemia in pregnancy, there is still uncertainty about how best this should be investigated, prevented and managed. This reflects the limitations of laboratory tests, as well as the poor understanding of how best to replace iron, given the complex physiological mechanisms of iron absorption and distribution. A strategy for iron replacement in a population of anaemic pregnant women needs to be developed not only based on what is biologically and clinically most appropriate but also in the context of each organisation's delivery of care structure, taking into consideration aspects of cost effectiveness. For this reason, management algorithms must be adapted locally, ensuring they meet basic clinical imperatives.

show abstract

“…This confirms the findings of a previous publication by our team that reported on 9 pregnancies, all of which were included in the current study. 2 The chronic anemia due to thalassemia in addition to the physiological anemia in pregnancy (secondary to increased fluid compartment of the body) may partly explain some of the complications of the pregnant TI mothers. 3 Although currently not a routine treatment approach for women with TI, some centers administer transfusion therapy during pregnancy to maintain Hb>10 g/dL to ensure appropriate fetal growth.…”

mentioning

confidence: 99%