Reproductive health issues in female patients with beta-thalassaemia major: a narrative literature review

Abstract

β-thalassaemia major (BTM) has a high prevalence worldwide and is associated with considerable morbidity and mortality. The aim of this review is to provide an illustrative overview of the reproductive health and pregnancy related issues in females with β-thalassaemia. A literature search was performed in four international databases (1980–2018) to identify the potentially relevant articles. Common reproductive health disorders are hypo-gonadotrophic hypogonadism, infertility, delayed or absent sexual development, diabetes, hypothyroidism, hypoparathyroidism, osteopenia, preeclampsia, gestational hypertension, polyhydramnios, oligohydramnios, thrombosis, renal failure, peripheral vascular resistance, placenta previa, pleural effusion and pulmonary hypertension. Many of those aspects are related to iron overload and to ineffective erythropoiesis. Foetal complications include neural tube defects, abnormalities in different organs, spontaneous abortion, foetal loss, preterm birth, foetal growth restriction and low birth weight. Antenatal screening and accurate genetic prenatal examinations are effective measures to early diagnosis of thalassaemia and a detailed plan for management of pregnancies in BTM is important for favourable maternal and foetal outcome.

Keywords:

• Thalassaemia major
• reproductive health
• pregnancy
• hypo-gonadotrophic hypogonadism
• foetal outcome

Acknowledgments

This publication was part of the Ph.D. thesis of M. Nourollahpour Shiadeh and was financially supported by Tehran University of Medical Sciences (grant. no IR.TUMS.FNM.REC.1397.039). The corresponding author thank the administrators of the Tehran University of Medical Sciences.

Disclosure statement

The authors do not have any conflict of interest to report regarding this manuscript.