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Pregnancy outcome in women with transfused beta-thalassemia in France

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Abstract

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.

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Authors and Affiliations

  1. Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 Place d’Arsonval 69003, Lyon, France

    Emilie Virot, Sabine Jardel, Giovanna Cannas & Arnaud Hot

  2. Département d’Hématologie Pédiatrique, Centre de Référence Français Des Thalassémies, Hôpital de La Timone, Marseille, France

    Isabelle Thuret

  3. Département d’Onco-Hématologie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France

    Raoul Herbrecht

  4. Département d’Hématologie, Hôpital de Bourgoin-Jallieu, Bourgoin-Jallieu, France

    Florence Lachenal

  5. Département de Médecine Interne, Hôpital Tenon, Paris, France

    François Lionnet

  6. Département de Médecine Interne, Centre Hospitalier d’Ajaccio, Ajaccio, France

    Marie-José Lucchini

  7. Département d’Hématologie, Centre Hospitalier de Roubaix, Roubaix, France

    Julie Machin

  8. Dépatement d’Hématologie, Centre Hospitalier Universitaire de Rennes, Rennes, France

    Stanislas Nimubona

  9. Département d’Hématologie Pédiatrique, Hôpital Necker, Paris, France

    Jean-Antoine Ribeil

  10. Département de Médecine Interne, Hôpital Henri Mondor, Créteil, France

    Frederic Galacteros

Authors
  1. Emilie Virot
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  2. Isabelle Thuret
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  3. Sabine Jardel
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  4. Raoul Herbrecht
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  8. Julie Machin
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  11. Frederic Galacteros
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Contributions

EV collected and interpreted the data, conducted the statistical analysis, wrote the manuscript, and gave final approval. SJ conducted the statistical analysis; IT, RH, FLa, FLi, MJL, JM, SN, BP, JAR, DS, CR, and FG included patients. GC included patients and reviewed the manuscript. AH included patients, interpreted the data, reviewed the manuscript, and gave final approval.

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Correspondence to Emilie Virot.

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Virot, E., Thuret, I., Jardel, S. et al. Pregnancy outcome in women with transfused beta-thalassemia in France. Ann Hematol 101, 289–296 (2022). https://doi.org/10.1007/s00277-021-04697-4

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  • DOI: https://doi.org/10.1007/s00277-021-04697-4

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