Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 Place d'Arsonval 69003, Lyon, France.
Département d'Hématologie Pédiatrique, Centre de Référence Français Des Thalassémies, Hôpital de La Timone, Marseille, France.
Ann Hematol. 2022 Feb;101(2):289-296. doi: 10.1007/s00277-021-04697-4. Epub 2021 Oct 20.
Because of chronic anemia, hypogonadotropic hypogonadism, and iron chelation, pregnancy in homozygous and heterozygous compound beta-thalassemia patients stays a challenge. Pregnancies of transfused beta-thalassemia women registered in the French National Registry, conducted between 1995 and 2015, are described. These pregnancies were compared with pregnancies in healthy women and to data previously published in the literature. Fifty-six pregnancies of 37 women were studied. There were 5 twin pregnancies. Assisted reproductive technologies (ART) were used in 9 pregnancies. Median term at delivery was 39 amenorrhea weeks, and median weight at birth was 2780 g. Cesarean section was performed in 53.6% of the pregnancies. There were 6 thromboembolic events, 6 serious infections, 6 pregnancy-induced hypertensions (PIH), 6 intrauterine growth retardations (IUGR), 5 severe hemorrhages, 4 gestational diabetes, 3 alloimmunizations, 2 heart diseases, and 1 pre-eclampsia. There were 5 infections and 4 osteoporosis in the first year of post-partum. ART and cesarean sections were more often used in the beta-thalassemia group, compared to control subjects. Thromboembolic events, PIH, hemorrhage at delivery, and IUGR were more frequent in the beta-thalassemia group. Time to delivery was not different, but infant weight at birth was significantly smaller in the beta-thalassemia group. In the post-partum period, global maternal complications were more frequent in the beta-thalassemia group. Pregnancy in transfused beta-thalassemia women is safe with rare obstetrical and fetal complications. Cesarean section remains often chosen, and infant weight at birth remains smaller than that in the general population, despite delivery at full term.
由于慢性贫血、低促性腺激素性性腺功能减退症和铁螯合作用，纯合子和杂合子复合β-地中海贫血患者的妊娠仍然是一个挑战。描述了在法国国家登记处登记的接受输血的β-地中海贫血女性的妊娠情况，这些妊娠发生在 1995 年至 2015 年之间。将这些妊娠与健康女性的妊娠以及之前文献中发表的数据进行了比较。研究了 37 名妇女的 56 次妊娠。有 5 例双胞胎妊娠。9 例妊娠采用了辅助生殖技术（ART）。中位分娩期为 39 周闭经，中位出生体重为 2780 克。53.6%的妊娠行剖宫产术。有 6 例血栓栓塞事件，6 例严重感染，6 例妊娠高血压（PIH），6 例宫内生长受限（IUGR），5 例严重出血，4 例妊娠糖尿病，3 例同种免疫，2 例心脏病，1 例子痫前期。产后第一年有 5 例感染和 4 例骨质疏松症。与对照组相比，ART 和剖宫产术在β-地中海贫血组中更常使用。血栓栓塞事件、PIH、分娩时出血和 IUGR 在β-地中海贫血组中更为常见。分娩时间无差异，但β-地中海贫血组婴儿出生体重明显较小。在产后期间，β-地中海贫血组的总体母体并发症更为常见。尽管在足月时分娩，但接受输血的β-地中海贫血妇女的妊娠是安全的，胎儿和产科并发症罕见。剖宫产术仍然经常选择，婴儿出生体重仍然小于普通人群。
