title: Pregnancy outcomes in women with thalassemia in North America and the United Kingdom.
abstract: Improved survival in thalassemia has refocused attention on quality of life, including family planning. Understanding the issues associated with infertility and adverse pregnancy outcomes may impact clinical care of patients with thalassemia. We report the number and outcomes of pregnancies among subjects enrolled in Thalassemia Clinical Research Network (TCRN) registries and examine variables associated with successful childbirth. We identified 129 pregnancies in 72 women among the 264 women, age 18 years or older in our dataset. Over 70% of pregnancies resulted in live births and 73/83 (88%) of live births occurred at full term. Most pregnancies (78.2%) were conceived without reproductive technologies. Most (59.3%) pregnancies occurred while on chronic transfusion programs, however only 38.9% were on iron chelation. Four women developed heart problems. Iron burden in women who had conceived was not significantly different from age- and diagnosis-matched controls that had never been pregnant. There was also no difference in pregnancy outcomes associated with diagnosis, transfusion status, diabetes or Hepatitis C infection. Pregnancies occurred in 27.3% of women with thalassemia of child-bearing age in the TCRN registries, a notable increase from our previous 2004 report. With optimal health maintenance, successful pregnancies may be achievable.
authors.affiliation: Division of Hematology-Oncology, Ann and Robert H. Lurie Children's Hospital of Chicago, IL 60611, USA. a-thompson@northwestern.edu
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Thompson
authors.forename: Hae-Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Sylvia T
authors.initials: ST
authors.lastname: Singer
authors.forename: Elliott
authors.initials: E
authors.lastname: Vichinsky
authors.forename: Jennifer
authors.initials: J
authors.lastname: Eile
authors.forename: Robert
authors.initials: R
authors.lastname: Yamashita
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Giardina
authors.forename: Nancy
authors.initials: N
authors.lastname: Olivieri
authors.forename: Nagina
authors.initials: N
authors.lastname: Parmar
authors.forename: Felicia
authors.initials: F
authors.lastname: Trachtenberg
authors.forename: Ellis J
authors.initials: EJ
authors.lastname: Neufeld
authors.forename: Janet L
authors.initials: JL
authors.lastname: Kwiatkowski
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D005260:Female; D006304:Health Status; D006801:Humans; D007501:Iron / Q000378:metabolism; D007502:Iron Chelating Agents / Q000627:therapeutic use; D050498:Live Birth / Q000453:epidemiology*; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D011247:Pregnancy; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D050497:Stillbirth / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology; D017086:beta-Thalassemia / Q000453:epidemiology* / Q000628:therapy
chemical_list: D007502:Iron Chelating Agents; D007501:Iron