Adler A, Wainstock T, Sheiner E. Prenatal exposure to maternal β-thalassemia minor and the risk for long-term hematologic morbidity in the offspring: A population-based cohort study.
Early Hum Dev 2021;
158:105397. [PMID:
34102479 DOI:
10.1016/j.earlhumdev.2021.105397]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 04/18/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE
β-Thalassemia has been shown to be associated with adverse short-term perinatal outcomes including low birth weight and preterm labor. The aim of this study was to assess whether in-utero exposure of maternal β-thalassemia minor is a risk factor for offspring hematological morbidity.
STUDY DESIGN
A population-based retrospective cohort study was conducted, including all infants born between the years 1991-2014 at a tertiary medical center. Long-term hospitalizations with hematologic morbidities were compared between offspring of mothers with or without β-thalassemia minor. Multiple gestations, perinatal mortality, chromosomal disorders and congenital malformations were excluded. Both study groups were followed until 18 years of age for hospitalization with hematological morbidities. Kaplan-Meier survival curve was used to compare the cumulative hematological morbidity incidence between both groups, and a Cox proportional hazard model was used to control for confounders.
RESULTS
During the study period, 243,682 deliveries met the inclusion criteria, of them 0.3% (n = 677) were of mothers with β-thalassemia minor. Among offspring to thalassemic versus non-thalassemic mothers, hospitalization rates involving hematological morbidity, were higher (3.3% vs. 0.7%, p < 0.001) a finding that was consistent with the Kaplan-Meier survival curve (log rank p < 0.001). Using Cox regression model, which adjusted for maternal age, SGA, gestational age and birth weight, maternal β-thalassemia minor was found to be an independent risk factor for long-term offspring hematological (aHR = 5.54; 95% CI 3.63-8.44, p < 0.001, 5.56; 95% CI 3.65-8.47, p < 0.001, and 5.49; 95% CI 3.60-8.36, p < 0.001, respectively).
CONCLUSION
Prenatal maternal β-thalassemia minor is independently associated with offspring long-term hematological morbidity.
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