The abstract for this study is reprinted below. The full study is attached to this post. This is the most definitive analysis of pregnancy in thalassemia that has been done to date.
Abstract:
Background
Recent advances in the management of thalassemia have significantly improved life expectancy
and quality of life of patients with this hemoglobinopathy, with a consequent increase in
their reproductive potential and desire to have children.
Design and Methods
We describe the methods of conception and delivery, as well as the course and outcome of
pregnancy including transfusions, iron overload and chelation in 46 women with thalassemia
major (58 pregnancies) and in 11 women with thalassemia intermedia (17 pregnancies).
Conception was achieved after gonadotrophin-induced ovulation in 33 of the women with
thalassemia major and spontaneously in all of those with thalassemia intermedia.
Results
Among the women with thalassemia major, 91% of the pregnancies resulted in successful
delivery of 45 singleton live-born neonates, five sets of twins and one set of triplets. No secondary
complications of iron overload developed or worsened during pregnancy. When considering
only the singleton pregnancies, the proportion of babies with intrauterine growth
retardation did not differ from that reported in the general Italian population. The high prevalence
of pre-term births (32.7%) was mostly related to multiple pregnancies and precautionary
reasons. Pregnancy was safe in most women with thalassemia major or intermedia. However,
women with thalassemia intermedia who had never previously been transfused or who had
received only minimal transfusion therapy were at risk of severe alloimmune anemia if blood
transfusions were required during pregnancy.
Conclusions
Provided that a multidisciplinary team is available, pregnancy is possible, safe and usually has
a favorable outcome in patients with thalassemia. In women with hypogonadotropic hypogonadism,
gonadal function is usually intact and fertility is usually retrievable.
The full text of this study is attached to this post as a pdf file. Please share this with any medical professionals who deal with pregnancy in thalassemia.
Citation: Origa R, Piga A, Quarta G, Forni GL, Longo F, Melpignano A, and Galanello R.
Pregnancy and b-thalassemia: an Italian multicenter experience. Haematologica. 2010; 95:376-
381. doi:10.3324/haematol.2009.012393
©2010 Ferrata Storti Foundation. This is an open-access paper