A Study Of 108 Pregnant Women With Thalassemia

Objective:An investigation was carried out on the pregnant women who were diagnosed with thalassaemia from obstetrical department of our hospital in 2017,the relevance ratio,distribution of genotype,nationality and native place of these patients were preliminarily investigated.To explore the value of erythrocyte parameters in the differentiation of pregnancy with thalassemia from iron deficiency anemia.The discriminant formula to identify pregnancy with thalassemia from iron deficiency anemia was established by linear stepwise regression analysis.Method:Collected and processed relevant clinical material and laboratory results of pregnant women whose first time prenatal examination were conducted in our obstetrician clinic from January 1,2017 to December 31,2017.The pregnant women who were diagnosed with thalassemia were grouped as group A,the pregnant women who were diagnosed with iron deficiency anemia were grouped as group B,the normal pregnant women were grouped as group C.The erythrocyte parameters of group A,group B and group C were analyzed,the identification formula was established by linear stepwise regression analysis.Results:(1)The cases of pregnant women with thalassemia were 108,relevance ratio was about 7.8%.Genotype:the cases of a-thalassemia were 45(41.67%),cases ofβ-thalassemia were 59(54.63%),cases of a combined with p thalassemia were 4(3.70%);Distribution of nationality:Han 28 cases(25.93%),Zhuang 20 cases(18.52%),Dai 18 cases(16.67%),Yi 12 cases(11.11%),Bai 10 cases(9.26%);Distribution of native place:Kunming 21 cases(19.44%),Wenshan 16 cases(14.81%),Dehong 15 cases(13.89%),Banna 13 cases(12.04%),Dali 11 cases(10.19%).(2)There was no significant difference in age and gestational age between group A,group B and group C(p>0.05).The difference in RBC,Hb,Hct,MCV,MCH,MCHC,RDW-CV,RDW-SD between group A,group B and group C were significant(p<0.05).There was no significant difference in MCH between group A and group B(p=0.066),the differences of other erythrocyte parameters were statistically significant(p<0.001).Cut-off values of the erythrocyte parameters to identify group A and group B were:RBC4.60×1012/L,Hb96g/L,Hct0.343L/L,MCV70.3fL,MCHC 288g/L,RDW-CV16.90%,RDW-SD43.6fl.The sensitivity was RBC>MCV>RDW-CV>RDW-SD= Hct>Hb>MCHC,specificity was RDW-SD>MCHC>RDW-CV>Hb>RBC>Hct>MCV,AUC of the erythrocyte parameter was AUCRDW-SD>AUCRDW-CV>AUCRBC>AUCHb>AUCMCHC>AUCHct>AUCmCV.(4)The formula to identify group A and group B was CF=-32.100-0.123× Hb +0.347× MCV+1.101 ×RDW-CV,it’s sensitivity was 0.922,specificity was 0.898,PPV was 0.897,NPV was 0.923,youden index was 0.820,accuracy was 0.910.Conclusions:The relevance ratio of pregnancy complicating thalassemia in obstetrical department of our hospital was relatively high,it’s in line with the national and geographical distribution characteristics of the thalassemia in Yunnan province.The identification efficacy of erythrocyte parameters in pregnancy combined with thalassemia and iron deficiency anemia was RDW-SD>RDW-CV>RBC>Hb>MCHC>Hct>MCV;The formula CF=-32.10-0.123 ×Hb +0.347 ×MCV +1.101 ×RDW-CV has a certain clinical value in the identification of pregnancy with thalassaemia and iron deficiency anemia.