Analysis Of The Effect Of Iron Deficiency On Maternal And Perinatal Infant In Thalassemia

Objective:Through retrospective analysis of the clinical data of thalassemia mothers,the distribution of thalassemia genotypes among pregnant women in the region was investigated;the perinatal blood indicators and maternal and infant outcomes of thalassemia patients in the two groups with and without iron deficiency were compared,and the correlation between ferritin and erythrocyte indicators was analyzed to investigate the effect of iron deficiency on the perinatal erythrocyte-related indicators and maternal and infant outcomes of thalassemia patients,so as to provide a basis for further standardized management of maternal health care and scientific diagnosis and treatment of iron deficiency.Methods:(1)To collect the hospitalization information of 784 thalassemia patients who delivered in our obstetrics department from January 01,2019 to December 31,2021,record the thalassemia genotype of each case,and count the number and percentage of each thalassemia genotype.(2)Among them,patients with resting and mild thalassemia(757 cases)were selected,and the collected cases were divided into two groups according to serum ferritin(SF)levels,with SF<20 ng/ml for group A(202 cases)and SF≥20 ng/ml for group B(555 cases).Erythrocyte-related indexes in the blood routine of cases in both groups were collected,including hemoglobin(Hb)value,red blood cell(RBC)count,mean red blood cell volume(MCV),mean hemoglobin content(MCH),coefficient of variation of red blood cell distribution width(RDW-CV),standard deviation of red blood cell distribution width(RDW-SD)and maternal and infant outcomes(mode of delivery,preterm delivery,postpartum hemorrhage,neonatal birth weight,neonatal Apgar score at 1 minute,and neonatal transfer rate within seven days),and the SPSS26.0 data analysis software was used to analyze the variability of each of these observations between the two groups and the correlation between ferritin and the observations.Results:(1)Among the 784 patients,522 patients with α-thalassemia,206 patients withβ-thalassemia,and 56 patients with α-complex β-thalassemia accounted for 66.58%,26.28%,and 7.17% of the total,respectively;17 genotypes were detected among the 522 patients withα-thalassemia,of which the most common ones were αα/--SEA(263 cases,50.38%),αα/-α3.7(100 cases,19.16%),αα/αCSα(54 cases,10.34%);a total of 10 genotypes were detected in206 patients with β-thalassemia,the most common of which were β17/βN(107 cases,51.94%),β41-42/βN(64 cases,31.07%).(2)The differences in Hb values,RBC counts,MCV and MCH levels between the two groups were statistically significant(P<0.05);the differences in RDW-CV and RDW-SD levels between the two groups were not statistically significant(P>0.05).(3)There was a statistically significant difference in the incidence of preterm delivery between the two groups(P<0.05);there was no statistically significant difference in the mode of delivery,postpartum hemorrhage rate,neonatal birth weight,neonatal 1-minute Apgar score and neonatal transfer rate within seven days between the two groups(P>0.05).(4)When SF <20ng/ml,there was a positive correlation between SF value and Hb,MCV,MCH,and a negative correlation with RDW-CV;when SF ≥20ng/ml,there was no significant correlation between SF and MCV,MCH,RDW-CV,and RDW-SD(P>0.05);when SF≥100ng/ml,there was a negative correlation between SF value and RBC count;when SF ≥120 ng/ml,there was a moderate negative correlation between SF and Hb(P<0.05),and |r|values were higher than other SF ranges.(5)The difference in SF levels between the preterm and term birth groups was statistically significant(P<0.05),while the difference in SF levels between the remaining maternal and infant outcome groups was not statistically significant(P>0.05).Conclusion:(1)Thalassemic pregnant women with combined iron deficiency had significantly lower Hb values,RBC counts,MCV,MCH,and no significant changes in RDW-CV and RDW-SD levels.(2)Pregnant women with thalassemia combined with iron deficiency had a higher risk of preterm delivery and no significant increase in the risk of postpartum hemorrhage,neonatal asphyxia,low birth weight,neonatal transfer and cesarean delivery.(3)When SF <20ng/ml,the higher the SF level,the higher the Hb value,MCV,MCH,and the smaller the RDW-CV;when SF ≥100ng/ml,the higher the SF level,the smaller the RBC count;when SF ≥120ng/ml,the Hb decreased more as SF increased;when SF≥20ng/ml,the SF level had no significant effect on MCV,MCH,RDW-CV RDW-CV,RDW-SD had no significant effect.(4)Decreased SF levels increase the risk of preterm delivery and have no significant effect on postpartum hemorrhage,neonatal asphyxia,low birth weight,neonatal transfer,or cesarean delivery.