Traisrisilp Kuntharee, Jatavan Phudit, Tongsong Theera
a Department of Obstetrics and Gynecology, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand.
J Obstet Gynaecol. 2017 Nov;37(8):1000-1003. doi: 10.1080/01443615.2017.1313822. Epub 2017 Jun 9.
The objective of this retrospective cohort study was to compare pregnancy outcomes between low-risk pregnant women with alpha-thalassaemia-1 trait and normal controls. The database of the Maternal-Foetal Medicine unit was used to identify low-risk singleton pregnant women complicated by alpha-thalassaemia-1 trait who gave birth between January 2002 and October 2014. The low-risk pregnancies with non-carrier status for thalassaemia were assigned into the control group, with a control-to-case ratio of 10:1. During the study period, 595 women with alpha-thalassaemia-1 trait and 5950 normal controls were identified. There was no significant difference in the incidence of preterm birth and most obstetric outcomes between the two groups. However, a statistically significant difference was detected between them in terms of gestational age at delivery, 37.76 ± 2.81 vs. 38.11 ± 2.50 weeks (p = .001), birth weight, 2876 ± 581 vs. 2948 ± 527 g (p = .002) as well as the rate of low-birth weight, 17.1 vs. 12.8% (p = .002). In conclusion, this study provides new insights that alpha-thalassaemia-1 trait has minimal effect on gestational age at delivery and low-birth weight whereas other common adverse pregnancy outcomes are not increased. Impact statement What is already known on this subject: Thalassaemia trait is associated with some degree of anaemia. What the results of this study add: The prevalence of common adverse outcomes such as preterm birth, stillbirth, low Apgar scores and pregnancy-induced hypertension were not significantly different between both the groups, possibly caused by too small sample size to gain enough power. However, the rate of low-birth weight was significantly increased among pregnancy with alpha-thalassaemia-1 trait. What the implications are of these findings for clinical practice and/or further research: The information may be provided for alpha thalassaemia-1 trait mothers and their families. Physicians should guard against the occurrence of adverse pregnancy in these mothers. Prospective control study should be conducted to overcome the limitation of retrospective nature.
这项回顾性队列研究的目的是比较携带α地中海贫血1特征的低风险孕妇与正常对照组之间的妊娠结局。利用母胎医学科的数据库，确定了2002年1月至2014年10月期间分娩的患有α地中海贫血1特征的低风险单胎孕妇。将无地中海贫血携带状态的低风险妊娠归入对照组，对照组与病例组的比例为10:1。在研究期间，共确定了595名携带α地中海贫血1特征的女性和5950名正常对照。两组之间早产发生率和大多数产科结局无显著差异。然而，两组在分娩孕周方面存在统计学显著差异，分别为37.76±2.81周和38.11±2.50周（p = 0.001），出生体重分别为2876±581克和2948±527克（p = 0.002），以及低出生体重率分别为17.1%和12.8%（p = 0.002）。总之，本研究提供了新的见解，即α地中海贫血1特征对分娩孕周和低出生体重影响极小，而其他常见的不良妊娠结局并未增加。影响声明关于该主题已知的信息：地中海贫血特征与一定程度的贫血有关。本研究结果补充的内容：两组之间早产、死产、低Apgar评分和妊娠高血压等常见不良结局的发生率无显著差异，可能是由于样本量太小而无法获得足够的检验效能。然而，携带α地中海贫血1特征的妊娠中低出生体重率显著增加。这些发现对临床实践和/或进一步研究的意义：可为携带α地中海贫血1特征的母亲及其家人提供相关信息。医生应警惕这些母亲发生不良妊娠情况。应进行前瞻性对照研究以克服回顾性研究的局限性。
