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轻度β地中海贫血孕妇的妊娠期糖尿病:一项配对病例对照研究。

Gestational Diabetes Mellitus in Pregnant Women with Beta-Thalassemia Minor: A Matched Case-Control Study.

作者信息

Falcone Veronica, Heinzl Florian, Itariu Bianca Karla, Reischer Theresa, Springer Stephanie, Muin Dana Anaïs, Pateisky Petra, Foessleitner Philipp, Ott Johannes, Farr Alex, Rosta Klara

机构信息

Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria.

Department of Internal Medicine III, Division of Endocrinology and Metabolism Diseases, Medical University of Vienna, 1090 Vienna, Austria.

出版信息

J Clin Med. 2022 Apr 6;11(7):2050. doi: 10.3390/jcm11072050.

Abstract

Pregnancy in women with thalassemia minor is considered safe. However, a higher incidence of maternal and neonatal complications in women with the disorder has been reported in the literature. This study aimed to determine whether there is an increased risk of gestational diabetes mellitus (GDM) in pregnant women with beta-thalassemia minor. We conducted a retrospective matched case-control study of 230 pregnant women who delivered at the Department of Obstetrics and Feto-Maternal Medicine at the Medical University of Vienna between the years 2008 and 2020, whereof 115 women had beta-thalassemia minor. We found no significant difference in the occurrence of GDM between the case group and control group of age and BMI-matched healthy women. However, we observed a significantly lower hemoglobin (Hb) and hematocrit (Ht) level during the first, the second, and the third trimesters of pregnancy, and postpartum (all: p < 0.001) among women with beta-thalassemia minor compared to the healthy controls. Neonates of women with beta-thalassemia were more likely to experience post-natal jaundice and excessive weight loss (p < 0.001). We conclude that GDM is not more likely to occur in pregnant women with beta-thalassemia minor. However, clinicians should be made aware of the risk of adverse maternal and neonatal outcomes. Furthermore, women with beta-thalassemia minor should undergo regular laboratory screening and multidisciplinary pregnancy care.

摘要

轻度地中海贫血女性的妊娠被认为是安全的。然而,文献报道称,患有该疾病的女性出现孕产妇和新生儿并发症的发生率较高。本研究旨在确定轻度β地中海贫血孕妇患妊娠期糖尿病(GDM)的风险是否增加。我们对2008年至2020年间在维也纳医科大学妇产科和母胎医学科分娩的230名孕妇进行了一项回顾性配对病例对照研究,其中115名女性患有轻度β地中海贫血。我们发现,年龄和体重指数匹配的健康女性病例组和对照组之间,GDM的发生率没有显著差异。然而,我们观察到,与健康对照组相比,轻度β地中海贫血女性在妊娠第一、第二和第三孕期以及产后的血红蛋白(Hb)和血细胞比容(Ht)水平显著较低(所有p<0.001)。轻度β地中海贫血女性的新生儿更易出现产后黄疸和体重过度减轻(p<0.001)。我们得出结论,轻度β地中海贫血孕妇患GDM的可能性并不更高。然而,临床医生应意识到孕产妇和新生儿不良结局的风险。此外,轻度β地中海贫血女性应接受定期实验室筛查和多学科孕期护理。

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