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Beta-Thalassemia Minor During Pregnancy

Eyal Sheiner, MD^*, Amalia Levy, PhD, Ronit Yerushalmi, MD and Miriam Katz, MD^*

From the Departments of *Obstetrics and Gynecology, Epidemiology and Health Services Evaluation, and Hematology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er-Sheva, Israel.

Address reprint requests to: Eyal Sheiner, MD, Department of Obstetrics and Gynecology, Soroka University Medical Center, Box 151, Be'er-Sheva, Israel; e-mail: sheiner{at}bgumail.bgu.ac.il.

OBJECTIVE: To investigate pregnancy outcome of patients with ß-thalassemia minor.

METHODS: A population-based study comparing all pregnancies of women with and without ß-thalassemia minor was conducted. Deliveries occurred during the years 1988–2002 at Soroka University Medical Center. A multivariate logistic regression model, with backward elimination, was constructed to find independent risk factors associated with maternal ß-thalassemia minor.

RESULTS: During the study period there were 159,195 deliveries, of which 261 (0.2%) occurred in patients with ß-thalassemia minor. The following conditions were significantly associated with ß-thalassemia minor: oligohydramnios (odds ratio [OR] 2.1; 95% confidence interval [CI] 1.2%, 3.7%), intrauterine growth restriction (IUGR; OR 2.4; 95% CI 1.4%, 4.2%), Jewish ethnicity (OR 1.5; 95% CI 1.2%, 1.9%), and previous cesarean delivery (OR 1.4; 95% CI 1.1%, 2.0%). No significant differences were noted between the groups regarding perinatal outcomes such as birth weight, low Apgar scores, congenital malformations, or perinatal mortality. Patients with ß-thalassemia minor were more likely to have cesarean deliveries than were the nonthalassemic parturients (16.9% and 12.2%, respectively; P = .021). However, while controlling for possible confounders such as IUGR, oligohydramnios, and previous cesarean delivery, with another multivariate analysis with cesarean delivery as the outcome variable, ß-thalassemia minor was not found as an independent risk factor for cesarean delivery (OR 1.3; 95% CI 0.9%, 1.9%).

CONCLUSION: The course of pregnancy of patients with thalassemia minor, including perinatal outcomes, is favorable. Because higher rates of IUGR were found, we recommend ultrasound surveillance of fetal weight for early detection of IUGR.

LEVEL OF EVIDENCE: II-2

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