Recent Study Links Transfusion-Dependent Thalassaemia to Adverse Maternal, Neonatal Outcomes
A meta-analysis of 15 studies found that pregnant women with β-thalassaemia major and β-thalassaemia intermedia were at greater risk of heart failure, venous thromboembolism, death, and other adverse neonatal and maternal outcomes. The findings were published in the journal Blood Advances.
The study was a systematic review and meta-analysis of reported outcomes from pregnancies involving mothers with thalassaemia major (TM) or thalassaemia intermedia (TI), involving a total of 429 participants and 684 pregnancies.
Regarding pregnancy outcomes, the meta-analysis indicated the risk of venous thromboembolism was 0.92% in individuals with TM, compared with 3.7% in individuals with TI. Heart failure risk in participants with TM was 1.6%, and in individuals with TI it was 1.1%.
Individuals with TM had a mortality rate that was reported to be 3.0% and a rate of pre-eclampsia of 11.3%, with a rate of gestational diabetes mellitus of 3.9%. Data on these complications were not available for individuals with TI.
Deliveries involved cesarean section at reported rates of 83.9% in the TM group and 67% in the TI group. Spontaneous miscarriage was reported at rates of 6.1% in the TM group and 9.5% in the TI group, and stillbirths occurred at rates of 1.3% in the TM group and 1.2% in the TI group.
Compared with prior to pregnancy, pooled mean serum ferritin levels postpartum had increased by 1005 ng/mL in individuals of the TM group and by 332 ng/mL in those of the TI group.
“Our findings indicate that pregnant patients with TM and TI are at risk of adverse maternal outcomes, including heart failure and mortality, if not managed using modern technologies such as MRI T2*, as well as adverse obstetric and fetal outcomes such as caesarean delivery and SGA size,” the researchers wrote in their report. They also highlighted specific risks with either TM or TI, and risks associated with cessation of iron chelation therapy during pregnancy.
Source: Vlachodimitropoulou E, Mogharbel H, Kuo KHM, et al. Pregnancy outcomes and iron status in β-thalassemia major and intermedia: a systematic review and meta-analysis. Blood Adv. 2024;8(3):746-757. doi:10.1182/bloodadvances.2023011636
