BMSEHA15
Published online 10 November 2009
Haematologica, Vol 95, Issue 3, 376-381 doi:10.3324/haematol.2009.012393
Copyright © 2010 by Ferrata Storti Foundation
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Thalassemia Syndromes

Pregnancy and β-thalassemia: an Italian multicenter experience

Raffaella Origa1, Antonio Piga2, Giovanni Quarta3, Gian Luca Forni4, Filomena Longo2, Angela Melpignano3, Renzo Galanello1

1 Ospedale Regionale per le Microcitemie, ASL Cagliari, Dipartimento di Scienze Biomediche e Biotecnologie, Università di Cagliari, Cagliari;
2 Centro Microcitemie, Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Torino;
3 Divisione di Ematologia, Ospedale "Perrino" Brindisi and
4 Centro della Microcitemia e Anemie Congenite, Ospedali Galliera, Genova, Italy

Correspondence: Renzo Galanello, Ospedale Regionale Microcitemie, ASL Cagliari, Dipartimento di Scienze Biomediche e Biotecnologie Università di Cagliari, Via Jenner s/n, 09121 Cagliari, Italy. E-mail: renzo.galanello{at}mcweb.unica.it

Background: Recent advances in the management of thalassemia have significantly improved life expectancy and quality of life of patients with this hemoglobinopathy, with a consequent increase in their reproductive potential and desire to have children.

Design and Methods: We describe the methods of conception and delivery, as well as the course and outcome of pregnancy including transfusions, iron overload and chelation in 46 women with thalassemia major (58 pregnancies) and in 11 women with thalassemia intermedia (17 pregnancies). Conception was achieved after gonadotrophin-induced ovulation in 33 of the women with thalassemia major and spontaneously in all of those with thalassemia intermedia.

Results: Among the women with thalassemia major, 91% of the pregnancies resulted in successful delivery of 45 singleton live-born neonates, five sets of twins and one set of triplets. No secondary complications of iron overload developed or worsened during pregnancy. When considering only the singleton pregnancies, the proportion of babies with intrauterine growth retardation did not differ from that reported in the general Italian population. The high prevalence of pre-term births (32.7%) was mostly related to multiple pregnancies and precautionary reasons. Pregnancy was safe in most women with thalassemia major or intermedia. However, women with thalassemia intermedia who had never previously been transfused or who had received only minimal transfusion therapy were at risk of severe alloimmune anemia if blood transfusions were required during pregnancy.

Conclusions: Provided that a multidisciplinary team is available, pregnancy is possible, safe and usually has a favorable outcome in patients with thalassemia. In women with hypogonadotropic hypogonadism, gonadal function is usually intact and fertility is usually retrievable.

Key words: pregnancy, thalassemia major, thalassemia intermedia, hypogonadism, assisted reproduction.


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The life of patients with thalassemia major
Caterina Borgna-Pignatti
Haematologica 2010 95: 345-348. [Abstract] [Full Text] [PDF]



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C. Borgna-Pignatti
The life of patients with thalassemia major
Haematologica, March 1, 2010; 95(3): 345 - 348.
[Abstract] [Full Text] [PDF]