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St-Georges J, Alnoman A, Badeghiesh A, Baghlaf H. Pregnancy, delivery, and neonatal outcomes among women with beta-thalassemia major: a population-based study of a large US database. Arch Gynecol Obstet 2025; 311:1343-1349. [PMID: 39825900 PMCID: PMC12033207 DOI: 10.1007/s00404-024-07908-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 12/17/2024] [Indexed: 01/20/2025]
Abstract
PURPOSE We explored the effect of beta-thalassemia major on pregnancy and delivery outcomes in non-endemic area, utilizing USA population database. METHODS This is a retrospective study utilizing data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. A cohort of all deliveries between 2011 and 2014 was created using ICD-9 codes. The patients with beta-thalassemia major were identified and matched to patients without beta-thalassemia based on age, race, income quartile, and type of health insurance at a ratio of 1:20. The baseline characteristics were compared between the groups using Chi-square and Fischer's exact tests, as appropriate. The univariate and multivariate analyses were conducted for pregnancy, delivery and neonatal outcomes to estimate the unadjusted and adjusted odds ratio, respectively. RESULTS Out of 3,070,656 pregnancies over the study period, beta-thalassemia major complicated 445 pregnancies. The patients with beta-thalassemia were more likely to have thyroid disorders and previous C-section (p-value < 0.05). There were no differences in pregnancy outcomes such as gestational hypertension, preeclampsia, gestational diabetes, and placenta previa. C-section was 30% more likely to be the method of birth (aOR 1.30, 95%CI 1.03-1.63) and there was more than three-fold increase in rate of blood transfusion (aOR 4.69, 95% CI 3.02-7.28) among participants with beta-thalassemia major. Mothers with beta-thalassemia, almost, were 70% more likely to have a neonate small for gestational age (aOR 1.68, 95%CI 1.07-2.62). CONCLUSIONS Women with beta-thalassemia major are more likely to give birth by C-section, require blood transfusion and have small for gestational age neonates. Counseling patients with beta-thalassemia about these risks and increased antenatal surveillance is advised.
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Affiliation(s)
- Juliette St-Georges
- Department Obstetrics and Gynecology, Université de Montréal, Montréal, Canada.
| | - Abdullah Alnoman
- Department Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmad Badeghiesh
- Department of Obstetrics & Gynecology, King Abdulaziz University Rabigh Branch, Rabigh, Saudi Arabia
| | - Haitham Baghlaf
- Department of Obstetrics & Gynecology, University of Tabuk, Tabuk, Saudi Arabia
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Ewy J, Senapati S, Ali ND, Gracia CR. Special considerations in assisted reproductive technology for patients with hematologic disease. Fertil Steril 2025:S0015-0282(25)00240-7. [PMID: 40288481 DOI: 10.1016/j.fertnstert.2025.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2025] [Revised: 04/15/2025] [Accepted: 04/17/2025] [Indexed: 04/29/2025]
Abstract
Populations with hematologic disorders seeking fertility care often present with a complex clinical picture, including disease-specific sequelae and comorbid conditions. Limited literature exists to help guide fertility clinics on the management of these patients, many of whom require multidisciplinary care coordination centered on patient-specific fertility goals. Thanks to advancements in life-prolonging therapies for hematologic disorders, growing numbers of affected individuals are seeking assisted reproductive technologies for family building. Thus, it is important to be aware of the unique considerations and risks of assisted reproductive technologies for these populations and develop evidence-based care guidelines to optimize outcomes.
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Affiliation(s)
- Joshua Ewy
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Suneeta Senapati
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nadia D Ali
- Division of Hematology and Oncology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Clarisa R Gracia
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Li Y, Feng Y, Wei Y, Huang J, Chen H, Wei C, Wei K, Pang L. The impact of various types of α-thalassemia on perinatal complications and pregnancy outcomes in pregnant women. Ann Hematol 2025; 104:1541-1550. [PMID: 40019545 PMCID: PMC12031830 DOI: 10.1007/s00277-025-06287-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Accepted: 02/22/2025] [Indexed: 03/01/2025]
Abstract
This study aims to investigate the adverse effects of different types of α-thalassemia on pregnant women and their differences, so as to provide reference for the prevention and monitoring of perinatal complications in different types of α-thalassemia pregnancy. The observation group comprised 1371 singleton pregnant women with α-thalassemia, 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. The hemoglobin in the experimental group was lower than control group. The incidences of electrocardiographic abnormality, abnormal liver function, hypertensive disorders, gestational diabetes mellitus and thyroid disorders during pregnancy were higher in the observation group than in the control group. The incidences of preterm labor, caesarean section and postpartum hemorrhage were all higher in the observation group than in the control group. The delivery weight and neonatal hemoglobin in the observation group were lower than those in the control group. Pregnant women with α-thalassemia have more pregnancy and delivery complications than those without α-thalassemia, they should receive more frequent and standardized prenatal examination, so as to find and correct abnormal indicators in time.
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Affiliation(s)
- Yi Li
- Department of Prenatal Diagnosis and Genetic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
- The First Affiliated Hospital, Center for a Combination of Obstetrics and Gynecology &Reproductive Medicine, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Yuanyuan Feng
- Department of Prenatal Diagnosis and Genetic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
- Department of Obstetrics and Gynecology, The Maternity and Child Health Hospital of Guangxi Zhuang Autonomous Regin, Nanning, Guangxi, 530002, China
| | - Yiyun Wei
- Department of Prenatal Diagnosis and Genetic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Jing Huang
- Department of Obstetrics and Gynecology, The Maternity and Child Health Hospital of Guangxi Zhuang Autonomous Regin, Nanning, Guangxi, 530002, China
| | - Hui Chen
- Department of Prenatal Diagnosis and Genetic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Changqiang Wei
- Department of Prenatal Diagnosis and Genetic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Kaiyi Wei
- Department of Prenatal Diagnosis and Genetic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Lihong Pang
- Department of Prenatal Diagnosis and Genetic Diagnosis, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China.
- Guangxi Key Laboratory of Thalassemia Research, Nanning, Guangxi, 530002, China.
- NHC Key Laboratory of Thalassemia Medicine, Guangxi Medical University), Nanning, Guangxi, 530002, China.
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University, Ministry of Education, Nanning, Guangxi, 530002, China.
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Nanning, Guangxi, 530002, China.
- The First Affiliated Hospital of Guangxi Medical University, NO.6 Shuangyong road, Nanning, 530021, P.R. China.
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Sawh RN. The patient perspective: The struggles of living with thalassemia as an adult. Ann N Y Acad Sci 2023; 1527:20-24. [PMID: 37468233 DOI: 10.1111/nyas.15040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Today it has become the norm for individuals diagnosed with severe forms of thalassemia who have access to hypertransfusion regimens, chelation therapy, and annual surveillance to survive well beyond childhood. However, with this improvement in prognosis and subsequent transition to adult care, it has become apparent that most adult healthcare providers, including many adult hematologists and primary care providers, are ill-prepared to care for these patients and the complications that accompany their survival into adulthood. Collaborative efforts are needed to develop comprehensive approaches to contend with the challenges faced by adult patients to ensure they are properly managed and supported.
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Affiliation(s)
- Radhika N Sawh
- The Joan H. Marks Graduate Program in Human Genetics, Sarah Lawrence College, Bronxville, New York, USA
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