489 Pregnancy outcomes among women affected by thalassemia traits compared to normal controls

Abstract

To compare maternal and perinatal outcomes between groups of pregnant women diagnosed with thalassemia traits and normal controls. A retrospective cohort study was conducted on singleton pregnant women affected and not affected by thalassemia traits who attended in antenatal care clinic and delivered in Siriraj Hospital, Thailand. Thalassemia status for all subjects was indicated by hemoglobin typing and/or DNA analysis. Patients’ charts from January 2007 to December 2018 were reviewed. The control participants were randomly selected in the same period with a control-case ratio of approximately 1:1. Overall, 1288 women with thalassemia traits (348 of α thal-1 trait, 424 of β thal trait and 516 of HbE trait) and 1305 women in the control group were recruited. Maternal age, BMI and parity were similar between two groups. The hematocrit level at the 1st trimester in the thalassemia trait group was significantly lower than that in the control group (34.8±3.4% VS 36.9±3.0%; p<0.001). Table 1; the risk of pregnancy induced hypertension (PIH) and Apgar score < 7 at 1 minute were significantly higher in the thalassemia trait group compared to the control group (6.9% VS 4.7%, p=0.018 and 4.1% VS 2.5%, p=0.02). A subgroup was also analyzed between each thalassemia trait (Table 2), showing that the numbers of maternal anemia in the 1st and 3rd trimester were higher in all thalassemia traits compared to the normal group (p<0.001). β thal trait and HbE trait increased the risk of PIH with relative risk (RR) = 1.67 and 1.66, respectively. Additionally, the rate of neonates with Apgar score < 7 at 1 minute was significantly higher in the HbE trait; RR = 2.06. There was no significant difference in other maternal and neonatal outcomes. Thalassemia traits significantly increase the risk of hypertensive disorders in pregnancy and low Apgar score at 1 minute. Physiologic change during pregnancy may worsen the severity of anemia in pregnant women affected by thalassemia traits.View Large Image Figure ViewerDownload Hi-res image Download (PPT)