Foeto-maternal Outcome for Pregnant Women with Hemoglobinopathies in Basrah – Southern Iraq
Foeto-maternal Outcome
Keywords:
Pregnancy, anaemia, hemoglobinopathies, BasrahAbstract
Background: Anaemia is a significant global health concern. Hereditary haemoglobin abnormalities are one of the most frequent causes of anaemia in pregnant women. Pregnant women with Hemoglobinopathies are at increased risk for adverse pregnancy outcomes, such as preterm birth, intrauterine growth restriction, and low birth weight. The study aimed to determine the fate of pregnancies in women with hemoglobinopathies and to identify the predictors for adverse outcomes among these ladies.
Subjects and Methods: Acase-control study was conducted in Basrah Teaching Hospital for maternity and children from the 1st of September 2022 to the 1st of July 2023. One hundred nine women were included in the study, 33 ladies with sickle cell trait group, 22 ladies with thalassemia minor and 57 ladies as healthy controls. The socio-demographic, pregnancy-related characteristics, maternal morbidity, and maternal and fetal outcomes were assessed in this study.
Results: The current study found thatsickle cell trait has a higher risk of emergency C-section (20%), while Thalassemia minor has a higher risk of elective C-section (22.7%). Sickle cell traits significantly increase the risk of puerperal infection (23.3%), and they also increase the risk of urinary tract infection (20%). Hemoglobinopathies, particularly sickle cell trait, significantly increase the risk of gestational diabetes mellitus (16.7%), but there is no significant increment in the risk of other maternal outcomes. Both sickle cell trait and thalassemia minor are significantly associated with lower BMI, lower Hb, and lower serum ferritin levels (P-value < 0.05).
Conclusion: Sickle cell trait and thalassemia minor increase the risk of poor maternal and fetal outcomes.
References
Cappellini MD, Motta I. Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change With Aging?. SeminHematol. 2015;52(4):261-269.
World Health Organization. The global prevalence of anaemia in 2011. Geneva: WHO, 2015 (cited at May 21). Available at www.who.int/nutrition/publications/micronutrients/global_prevalence_anaemia_2011/en
Anaemia [Internet]. Who.int. 2023 [cited 2023 May 21]. Available from: https://www.who.int/health-topics/anaemia
Msuya SE, Hussein TH, Uriyo J, Sam NE, Stray-Pedersen B. Anaemia among pregnant women in northern Tanzania: prevalence, risk factors and effect on perinatal outcomes. Tanzan J Health Res. 2011;13(1):33-39.
Okube O. T., Mirie W., Odhiambo E., Sabina W., Habtu M. Prevalence and Factors Associated with Anaemia among Pregnant Women Attending Antenatal Clinic in the Second and Third Trimesters at Pumwani Maternity Hospital, Kenya. Open Journal of Obstetrics and Gynecology. 2016;06(01):16–27.
McClure EM, Meshnick SR, Mungai P, Malhotra I, King CL, Goldenberg RL, Hudgens MG, Siega-Riz AM, Dent AE. The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya. PLoSNegl Trop Dis. 2014;8(2):e2724.
Scott JA, Bass, BF. Hereditary anemia: Types of anemia that can be inherited [Internet]. Everydayhealth.com. 2010 [cited 2023 May 21].
Available from: https://www.everydayhealth.com/anemia/anemia-and-heredity.aspx.
Mbule MA, Byaruhanga YB, Kabahenda M, Lubowa A. Determinants of anaemia among pregnant women in rural Uganda. Rural Remote Health. 2013;13(2):2259.
Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Nutrition Impact Model Study Group (Anaemia). Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013 Jul;1(1):e16-25.
Gebre A, Mulugeta A. Prevalence of Anemia and Associated Factors among Pregnant Women in North Western Zone of Tigray, Northern Ethiopia: A Cross-Sectional Study. J NutrMetab. 2015;2015:165430.
Modell B, Darlison M. Global epidemiology of haemoglobin disorders and derived service indicators. Bull World Health Organ. 2008;86(6):480–487.
Piel FB, Steinberg MH, Rees DC. Sickle Cell Disease. N Engl J Med. 2017;376(16):1561-1573.
Smith-Whitley K. Complications in pregnant women with sickle cell disease. Hematology Am SocHematolEduc Program. 2019;2019(1):359-366.
Harteveld CL, Higgs DR. Alpha-thalassaemia. Orphanet J Rare Dis. 2010;5:13.
Balgir RS. Prevalence of Hemolytic Anemia and Hemoglobinopathies among the Pregnant Women Attending a Tertiary Hospital in Central India. Thalassemia Reports. 2015; 5(1):4644.
Kasparek J, Burkhardt T, Hoesli I, AmstadBencaiova G. Pregnancy outcomes in women with a hemoglobinopathy trait: a multicenter, retrospective study. Arch Gynecol Obstet. 2021;304(5):1197-1203.
Hamamy HA, Al-Allawi NA. Epidemiological profile of common haemoglobinopathies in Arab countries. J Community Genet. 2013 ;4(2):147-67.
Jans SM, de Jonge A, Lagro-Janssen AL. Maternal and perinatal outcomes amongst haemoglobinopathy carriers: a systematic review. Int J ClinPract. 2010;64(12):1688-98.
Kemthong W, Jatavan P, Traisrisilp K, Tongsong T. Pregnancy outcomes among women with hemoglobin E trait. J Matern Fetal Neonatal Med. 2016;29(7):1146–1148.
Nath KA, Hebbel RP. Sickle cell disease: renal manifestations and mechanisms. Nat Rev Nephrol. 2015;11(3):161-71.
Hanprasertpong T, Kor-anantakul O, Leetanaporn R, Suntharasaj T, Suwanrath C, Pruksanusak N, Pranpanus S. Pregnancy outcomes amongst thalassemia traits. Arch Gynecol Obstet. 2013;288(5):1051-4.
Charoenboon C, Jatavan P, Traisrisilp K, Tongsong T. Pregnancy outcomes among women with beta-thalassemia trait. Arch Gynecol Obstet. 2016;293(4):771-4.
Asare EV, Olayemi E, Adomakoh Y, Mensah E, Swarray-Deen A, Ghansah H, et al. Low body mass index in pregnant women with sickle cell disease is associated with premature delivery in sub- Saharan Africa. Blood. 2017; 130:2250.
