Department of Maternity-Child Health and Family Planning Services, Affiliated Nanning Maternal and Child Health Hospital of Guangxi Medical University, No. 20 Liwan Road, Qingxiu District, Nanning City, 530022, Guangxi Province, China.
Sci Rep. 2021 Aug 27;11(1):17305. doi: 10.1038/s41598-021-95998-1.
To evaluate the possible associations between fetal α-thalassemia and risk of adverse pregnancy outcomes using a provincial woman-child health service information database in China. This was a case control study (N = 438,747) in which we compared all singleton pregnancies of women with or without the α-thalassemia trait from May 2016 to May 2020, and where women with the trait were further allocated to a normal fetal group, a group of fetuses with the α-thalassemia trait, and a fetal group with hemoglobin H (HbH) disease according to the results of fetal DNA analysis. With thalassemic women whose fetuses were normal as the reference, fetuses in the HbH disease group showed a higher increase in the odds of Apgar scores being < 7 at 1 min (adjusted odds ratio [aOR], 2.79; 1.03-7.59) and 5 min (aOR, 4.56; 1.07-19.40). With non-thalassemic women as the reference, these trends were more obvious (aOR, 4.83; 2.55-9.16; aOR, 6.24; 2.75-14.18, respectively); whereas the normal fetal group was more likely to be diagnosed with postpartum hemorrhage (aOR, 1.66; 1.10-2.50). In addition, fetal HbH disease and gestational age were two independent factors influencing low Apgar scores, and their combination reflected medium accuracy in Apgar predictions.
利用中国省级母婴健康服务信息数据库，评估胎儿α-地中海贫血与不良妊娠结局风险之间的可能关联。
本病例对照研究（N=438747）比较了 2016 年 5 月至 2020 年 5 月期间患有或不患有α-地中海贫血特征的所有单胎妊娠，并根据胎儿 DNA 分析结果，将具有α-地中海贫血特征的女性进一步分为正常胎儿组、胎儿α-地中海贫血特征组和血红蛋白 H（HbH）病胎儿组。以胎儿正常的地中海贫血女性为参照，HbH 病胎儿组的 1 分钟（调整后的优势比[aOR]，2.79；1.03-7.59）和 5 分钟（aOR，4.56；1.07-19.40）时 Apgar 评分<7 的几率增加更高。以非地中海贫血女性为参照，这些趋势更为明显（aOR，4.83；2.55-9.16；aOR，6.24；2.75-14.18）；而正常胎儿组更易发生产后出血（aOR，1.66；1.10-2.50）。此外，胎儿 HbH 病和胎龄是影响低 Apgar 评分的两个独立因素，两者结合反映了 Apgar 预测的中等准确性。
