Pregnancy Outcomes in Women Affected by Fetal Alpha-thalassemia: A Case Control Study

Abstract

To evaluate the possible associations between fetal α-thalassemia and risk of adverse pregnancy outcomes using a provincial woman-child health service information database in China. This was a case control study (N=438,747) in which we compared all singleton pregnancies of women with or without the α-thalassemia trait from May 2016 to May 2020, and where women with the trait were further allocated to a normal fetal group, a group of fetuses with the α-thalassemia trait, and a fetal group with hemoglobin H (HbH) disease according to the results of fetal DNA analysis. With thalassemic women whose fetuses were normal as the reference, fetuses in the HbH disease group showed a higher increase in the odds of Apgar scores being <7 at 1 minute (adjusted odds ratio [aOR], 2.79; 1.03–7.59) and 5 minutes (aOR, 4.56; 1.07–19.40). With non-thalassemic women as the reference, these trends were more obvious (aOR, 4.83; 2.55–9.16; aOR, 6.24; 2.75–14.18, respectively); whereas the normal fetal group was more likely to be diagnosed with postpartum hemorrhage (aOR, 1.66; 1.10–2.50). In addition, fetal HbH disease and gestational age were two independent factors influencing low Apgar scores, and their combination reflected medium accuracy in Apgar predictions.

Relationship between maternal age and the risk of adverse pregnancy outcomes: a retrospective cohort study in China

“…For infant outcomes, preterm birth was de ned as delivery before 37 weeks of gestation. Low birth weight was described as a birth weight less than 2,500 g, and macrosomia greater than 4,000 g. SGA referred to a birth weight less than the 10th percentile for its gestational age [14]. Low Apgar score referred to a score less than 7 at 5 min after birth.…”

“…Information from antenatal care, delivery, newborns, and child death for all births was abstracted from the medical records into this data system, a provincial database administered by the Guangxi Health Commission. The data entry and quality control methods were carried out per prior regulations [14].…”

Effects of thalassemia on pregnancy outcomes of women with gestational diabetes mellitus

“…Perhaps because of different thalassemia types in these studies, researchers came to inconsistent conclusions. The relatively consistent conclusion was that thalassemia in pregnancy could increase the risk of pregnancy outcomes, such as preeclampsia, 5 cesarean section, 6 premature birth, 6,7 low‐birth weight, 8,9 and Apgar score <7 at 1 min 10 . Therefore, it is necessary to further explore the influence of different types of thalassemia on pregnancy outcomes.…”