THE ASSOCIATION OF LOW HEMOGLOBIN WITH THE RISK OF ADVERSE FETOMATERNAL OUTCOMES IN PATIENTS OF THALASSEMIA MINOR - A COHORT STUDY

Background: Beta-thalassemia minor is generally considered a benign carrier state; however, emerging evidence suggests it may be associated with adverse maternal and neonatal outcomes, especially when compounded by anemia during pregnancy. Understanding this relationship is crucial for developing targeted antenatal care strategies in regions where thalassemia is prevalent. Objective: To determine the association of low hemoglobin levels with the risk of adverse feto-maternal outcomes in pregnant women diagnosed with beta-thalassemia minor. Methods: A prospective cohort study was conducted at Gynae C Unit, MTI-KTH Peshawar, over six months. A total of 158 pregnant women were enrolled, equally divided into exposed (beta-thalassemia minor with low Hb) and non-exposed (without thalassemia, normal Hb) groups using non-probability consecutive sampling. Data on demographics, hemoglobin levels, obstetric history, and adverse outcomes were recorded. Outcomes assessed included preterm birth, low birth weight, neonatal anemia, IUGR, maternal anemia, need for blood transfusion, and oligohydramnios. Data were analyzed using SPSS v23.0; relative risk (RR) and Chi-square tests were applied, with p < 0.05 considered statistically significant. Results: Adverse outcomes were significantly more frequent in the exposed group. Preterm birth (24.1% vs. 10.1%), low birth weight (32.9% vs. 15.2%), neonatal anemia (26.6% vs. 11.4%), IUGR (21.5% vs. 8.9%), and maternal anemia (48.1% vs. 17.7%) were all more prevalent among women with beta-thalassemia minor. Blood transfusion and oligohydramnios were also notably higher in the exposed group. Conclusion: Beta-thalassemia minor with low hemoglobin is significantly associated with adverse feto-maternal outcomes. These findings highlight the need for early screening and enhanced antenatal surveillance in affected pregnancies to mitigate risks.