Effect Of Minor Thalassemia On Perinatal Outcome Of Twin Pregnancy

Objective: This essay aims to investigate the effect of minor thalassemia on maternal and infant outcome of twin pregnancy,and to provide scientific basis for promoting maternal and infant health of twin pregnancy with minor thalassemia.Methods: The retrospective study starts from 42 cases of twin pregnancy with minor thalassemia,197 cases of twin pregnancy without thalassemia,173 cases of single pregnancy with minor thalassemia delivered in the First Affiliated Hospital of Guangxi Medical University(between January 2013 and December 2019)and this study is to make an analysis of the clinical document.Maternal data include gene type of thalassemia,mother’s age,prepregnancy body mass index(PBIM),gravidity and parity history,the mode of conception,type of twin pregnancy,scar uterus.Pregnancy complications include preterm birth,abnormal thyroid function,gestational diabetes mellitus(GDM),premature rupture of membranes(PROM),hypertensive disorder complicating pregnancy(HDP),intrahepatic cholestasis of pregnancy(ICP),oligohydramnios,polyhydramnios,placenta previa and placenta abruption.Pregnancy outcomes include delivery time,delivery mode,postpartum hemorrhage,neonatal weight and low birth weight infant.Drug using during pregnancy includes chalybeate and Chinese patent medicine for enriching blood and multivitamins.Hemoglobin(Hb)and serum ferritin(SF)levels and iron deficient anemia(IDA)in first trimester and before delivery.To compare the differences between the related indicators.Results:(1)Compared with the single-parental with minor thalassemia women,the twin pregnancy with and without minor thalassemia women had significantly higher rates of primipara proportion and using assisted reproductive technology and significantly higher median PBMI(all P<0.0167).Compared with the single-parental with minor thalassemia women,the twin pregnancy without thalassemia women had a significantly higher median age(P<0.0167).(2)Compared with the twin pregnancy without thalassemia women,the twin pregnancy with minor thalassemia women had a significantly lower level of mean Hb in the first trimester and median Hb before delivery(all P<0.0167).Compared with the single-parental with minor thalassemia women,the twin pregnancy with minor thalassemia women had a significantly lower level of median Hb before delivery,and a significantly higher declining level and ratio of mean Hb during pregnancy(all P<0.0167).Compared with the single-parental with minor thalassemia women,the level of mean Hb in the first trimester and the declining level and ratio of mean Hb during pregnancy in the twin pregnancy without thalassemia women were significantly higher(all P<0.0167).(3)Compared with the twin pregnancy without thalassemia women,the level of median SF in the first trimester and the level of the decrease of median SF during pregnancy in the twin pregnancy with minor thalassemia women and single-parental with minor thalassemia women were significantly higher(all P<0.0167).(4)The incidence of IDA before delivery in the twin thalassemia group was significantly higher than that in the twin without thalassemia group and the single thalassemia group(all P<0.0167).(5)There wasn’t significant difference in obstetrical complication between the twin pregnancy with and without minor thalassemia women(P>0.0167).Compared with the single-parental with minor thalassemia women,the twin pregnancy with minor thalassemia women had significantly higher incidences of preterm birth and HDP(all P<0.0167).Compared with the single-parental with minor thalassemia women,the incidences of preterm birth,GDM,HDP in the twin pregnancy without thalassemia women were significantly higher(all P<0.0167).(6)Compared with the single-parental with minor thalassemia women,the twin pregnancy with and without minor thalassemia women had significantly higher incidences of cesarean section and low birth weight of newborns,and had significantly larger median volume of postpartum hemorrhage,smaller median newborn birth weight and delivery gestational age(all P<0.0167).(7)Compared with the twin pregnancy without thalassemia women,the twin pregnancy with minor thalassemia women and the single-parental with minor thalassemia women had significantly higher rates of using chalybeate and Chinese patent medicine for enriching blood(all P<0.0167).Compared with the single-parental with thalassemia women,the twin pregnancy with minor thalassemia women had significantly higher rate of using Chinese patent medicine for enriching blood(P<0.0167).(8)Univariate analysis showed that comparing with the non-low birth weight group,the proportion of primipara,the incidence of premature delivery,PROM in the low birth weight group were higher,the incidence of abnormal thyroid function and cesarean section were lower,and the median gestational age was shorter(P<0.05).Multivariate logistic regression analysis showed that abnormal thyroid function was a risk factor for low birth weight infants in twin pregnancy.The incidence of low birth weight infants gradually decreased with the prolongation of gestational age(P<0.05).Conclusion:(1)Minor thalassemia is not the main factor affecting the complications of pregnancy,gestational age,delivery mode and postpartum hemorrhage of twin pregnancy.(2)IDA can be found in the pregnant women with minor thalassemia.For the twin pregnant women with minor thalassemia,more attention should be paid to the change of SF during pregnancy and supplementing iron timely.(3)Twin and gestational age of delivery are the main factors affecting the birth weight of newborns in twin pregnancy with minor thalassemia.