Pregnancy outcomes in women affected by fetal alpha-thalassemia: a case
control study
Abstract
Objective: To evaluate the associations between fetal α-thalassemia and
risk of adverse pregnancy outcomes. Design: Case control study. Setting:
Forty-two hospitals in Nanning, China. Participants: Pregnant women
>20 weeks of gestation. Methods: Multivariate logistic
regression analyses were performed to explore associations between fetal
α-thalassemia and adverse pregnancy outcomes. Receiver operating
characteristic curve analyses were used to assess the use of selected
factors in predicting low Apgar scores. Main Outcome and Measure:
Pregnancy outcomes of thalassemic women whose fetuses had
non-thalassemia, α-thalassemia trait or HbH disease. Results: 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 (4.74% vs 1.57%) and 5 minutes
(2.84% vs 0.67%). With non-thalassemic women as the reference, this
trend was more obvious; whereas the normal fetal group was more likely
to be diagnosed with postpartum hemorrhage. Combining fetal HbH disease
and gestational age reflected medium accuracy in Apgar predictions.
Conclusions: Fetal HbH disease was associated with a higher risk of low
Apgar scores. Thalassemic women with normal fetuses may also have an
increased risk of postpartum hemorrhage, and should be monitored
accordingly. Funding: The Key Research and Development Programs of
Nanning, China (No. 20183038 and No. 20193097). Keywords: Fetal
alpha-thalassemia; Low Apgar scores; Postpartum hemorrhage. Tweetable
abstract: This study shows that fetal HbH disease may increase the risk
of low Apgar scores, and that thalassemic women with normal fetuses are
prone to postpartum hemorrhage.