O'Donnell A, Raiko A, Clegg J B, Weatherall D J, Allen S J
Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, UK.
Br J Haematol. 2006 Oct;135(2):235-41. doi: 10.1111/j.1365-2141.2006.06274.x. Epub 2006 Aug 25.
The effect of maternal alpha+ -thalassaemia on pregnancy was assessed in the north coastal region of Papua New Guinea (PNG), where malaria is hyperendemic and alpha+ -thalassaemia is extremely common. In a prospective study of 987 singleton hospital deliveries, we correlated maternal alpha-globin genotype with markers of reproductive fitness (age in primigravidae, gravidity, pregnancy interval and the number of miscarriages and stillbirths), Plasmodium falciparum(P. falciparum) infection of the mother and placenta, maternal haemoglobin, preterm delivery and birthweight. The frequency of the -alpha genotype in mothers was 0.61. Markers of reproductive fitness were similar in women with and without alpha+ -thalassaemia. Median haemoglobin concentration during pregnancy and after delivery was about 1.0 g/dl lower in homozygous alpha+ -thalassaemia than in women with a normal alpha- globin genotype (P < or = 0.001). The frequency of placental P. falciparum infection and systemic malaria infection after delivery showed no consistent relationship to alpha-globin genotype. The frequency of preterm delivery and low birthweight did not vary significantly according to maternal alpha-globin genotype. Maternal alpha+ -thalassaemia does not affect reproductive fitness or susceptibility to malaria during pregnancy. Although median haemoglobin concentration was significantly lower in mothers homozygous for alpha+ -thalassaemia than those with a normal alpha-globin genotype, this did not result in an adverse outcome of pregnancy.
在疟疾高度流行且α+地中海贫血极为常见的巴布亚新几内亚北部沿海地区，评估了孕产妇α+地中海贫血对妊娠的影响。在一项对987例单胎医院分娩的前瞻性研究中，我们将孕产妇α珠蛋白基因型与生殖健康指标（初产妇年龄、妊娠次数、妊娠间隔以及流产和死产次数）、母亲和胎盘的恶性疟原虫感染、孕产妇血红蛋白、早产和出生体重进行了关联分析。母亲中-α基因型的频率为0.61。有无α+地中海贫血的女性生殖健康指标相似。纯合子α+地中海贫血患者孕期和产后血红蛋白浓度中位数比α珠蛋白基因型正常的女性低约1.0 g/dl（P≤0.001）。胎盘恶性疟原虫感染频率和产后系统性疟疾感染频率与α珠蛋白基因型无一致关系。早产和低出生体重的频率根据孕产妇α珠蛋白基因型无显著差异。孕产妇α+地中海贫血不影响妊娠期间的生殖健康或对疟疾的易感性。虽然纯合子α+地中海贫血母亲的血红蛋白浓度中位数显著低于α珠蛋白基因型正常的母亲，但这并未导致不良妊娠结局。
