Abstract
<p>To the best of our knowledge, there is no prospective trial study assessing the management of β-thalassemia by blood transfusion in pregnancy. The aim of this study was to investigate the effect of blood transfusion on maternal and neonatal outcomes in pregnant patients with beta thalassemia minor and intermedia. We did this randomized, single –blind, controlled clinical trial on 36 pregnant women with β thalassemia minor and intermedia at two tertiary hospitals of Imam Khomeini and Shafa in Ahvaz, Iran from January 2016 to July 2016. Patients were randomly assigned to receive either packed cell or not (control group) during pregnancy (ratio 1:1). The main outcomes of interest transfusion times, abortion, preterm delivery, type of delivery (cesarean or vaginal), stillbirth, birth weight, low birth weight, very low birth weight, small for gestational age, low Apgar score (≤7) at 1 and 5 minutes, oligohydramnios, fetal anomalies , and NICU admission. The median of blood transfusion in intervention group during pregnancy was two blood units. The cesarean section rate did not significantly differ between the intervention and control groups (72.2% and 44.4%, respectively, P=0.2). Two infants in intervention group experienced with LBW, one with SGA, one with low Apgar score, two with oligohydramnios, and one with NICU admission, while none in control group experienced these complications. The mean birth weight of infants in intervention group was significantly lower than control group (P value 0.002). The comparison between two groups showed that the adverse maternal and neonatal outcomes, especially low birth weight and preterm delivery were higher in intervention group.</p>
Highlights
Thalassemia syndrome is the most common inherited blood disorders worldwide (Traisrisilp, Luewan, & Tongsong, 2009; Whiteman et al, 2013)
To the bets of our knowledge, there is no clinical trial has investigated the effect of hemoglobin level modification with transfusion on pregnancy outcomes both on neonatal and maternal outcomes in pregnant women with beta thalassemia intermedia
Current clinical trial assessed the effect of hemoglobin level modification using transfusion on pregnancy outcomes including birth weight, preterm deliveries, abortion, cesarean section, low Apgar score (≤7), fetal anomaly, oligohydramnios and NICU admission in pregnancies with beta thalassemia intermdedia and minor
Summary
Thalassemia syndrome is the most common inherited blood disorders worldwide (Traisrisilp, Luewan, & Tongsong, 2009; Whiteman et al, 2013). Thalassemia is an inherited hemoglobin disorder in which mutated globin gene results in the various degrees of defects including globin production, an imbalance in alpha/beta globin chain synthesis, an ineffective erythropoiesis, and varying severity of disease and anemia (Howard, Tuck, Eissa, & Porter, 2015). It is the second reason for hypochromic anemia and anemia in pregnancy after iron deficiency (Yordanova et al, 2013).
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