Analysis of the Pregnancy Status and Outcomes of Pregnant Women with α-Thalassemia: A Retrospective Clinical Study

Background: The prevalence of α-thalassemia is high in Guangxi, and its co-occurrence with pregnancy may impede maternal system functions, with a consequent adverse effect on pregnancy progression and birth outcomes. The study objective was to compare the levels of relevant laboratory parameters, pregnancy complications, and birth outcomes of different types of α-thalassemia in pregnancy and to provide guidance on effective prevention and monitoring of perinatal complications in various types of α-thalassemia in pregnancy and improve associated pregnancy outcomes.

Methods: The observation group comprised 1371 singleton pregnant women with α-thalassemia. The control group comprised 680 non-thalassemia singleton pregnancies during the same period. The thalassemia genotypes of the observation group were tallied and categorized based on their respective genotypes within the group. All relevant clinical data were compared within and between groups.

Results:( 1) The ethnic distribution among the α-thalassemia pregnancies was predominantly Han and Zhuang, with the top three genotypes –SEA/ ααα, -α3.7/ααα, and αCSα/ααα. (2) The hemoglobin in the experimental group was lower than that in the control group, with the lowest hemoglobin in the intermediate group (P < 0.001), and serum ferritin trending in the opposite direction. The most significant decreases in hemoglobin and ferritin during pregnancy were observed in the intermediate group (P 0.001). (3) The incidences of abnormal Electrocardiograph, abnormal liver function, hypertensive disorders, Gestational Diabetes Mellitus and thyroid disorders during pregnancy were higher in the observation group than in the control group (P 0.05). (4) The incidences of preterm labor, caesarean section and postpartum hemorrhage were all higher in the observation group than in the control group (P 0.05). (5) The delivery weight and neonatal hemoglobin in the observation group were lower than those in the control group (P 0.05).

Conclusions: Pregnant women with α-thalassemia have the lowest hemoglobin levels, the highest serum ferritin levels, more complications of pregnancy and childbirth than non-thalassemic pregnancies.