Thalassemia affects your hemoglobin levels, potentially leading to anemia and other health problems. If you have thalassemia while pregnant, you have a high risk for complications. But with proper care and monitoring, it may be possible to have a healthy pregnancy.

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Thalassemia is an inherited condition that impacts your ability to make hemoglobin, the protein on red blood cells that carries oxygen. The effects of thalassemia can lead to anemia and several other health complications.

You may be at a higher risk of complications during pregnancy if you have thalassemia. However, treatment and monitoring can help lower your risk and preserve the health of both you and your baby.

Thalassemia is a condition where you make little or no hemoglobin. Hemoglobin is a very important part of red blood cells because it’s the protein that carries oxygen.

Red blood cells that lack hemoglobin cannot function properly to carry oxygen to the organs and tissues of your body. People who don’t have enough healthy red blood cells have a condition called anemia.

The effects of thalassemia and its treatment can raise a person’s risk of complications during their pregnancy.

Additionally, the increased demands that pregnancy places on the body can make existing thalassemia-related health issues, such as heart trouble or diabetes, worse.

Most of the symptoms of thalassemia are related to anemia. These can include:

The effects of thalassemia and its treatment can also lead to a variety of other health problems like:

Many people know they have thalassemia prior to pregnancy. Moderate to severe thalassemia is often detected early in life. Mild thalassemia may be diagnosed later when a child or adult sees a doctor for anemia symptoms or other health issues.

Thalassemia happens due to faulty hemoglobin genes. It’s an inherited condition, meaning that these faulty genes can be passed down (inherited) from your parents.

There are two general types of thalassemia: alpha and beta. These two types have different inheritance patterns and variations in severity. Generally speaking, you must receive faulty genes from both parents to have thalassemia.

Genetic testing

If you’ve been diagnosed with thalassemia, your doctor may recommend that your partner receive genetic testing prior to getting pregnant.

This testing can see whether your partner carries any of the faulty genes associated with thalassemia. Based on the results, a genetic counselor can then work with you to help you understand the risk of your child being born with thalassemia.

A diagnosis of thalassemia can be made during pregnancy by doing tests like a complete blood count, specialized hemoglobin tests, and genetic testing.

If you’ve been previously diagnosed with thalassemia and are looking to become pregnant, your doctor may do a variety of tests to assess your overall health and risk of pregnancy complications. These include:

Testing can also be used during your pregnancy to see if your baby has thalassemia. This can be done using chorionic villus sampling or amniocentesis.

If you have thalassemia while pregnant, your doctor will carefully monitor you throughout your pregnancy. This typically includes monthly appointments until 28 weeks, with monitoring every two weeks afterward.

During these visits, your doctor will check on your blood counts and the health of various organs, such as your heart, liver, and thyroid. You’ll also be tested for gestational diabetes at 16 weeks and possibly again at 28 weeks.

Blood transfusions

Some people with thalassemia require blood transfusions as a part of their treatment. As such, you’ll likely continue to receive transfusions during your pregnancy.

If you don’t typically require transfusions to treat your thalassemia, you may still need to have some during your pregnancy. This is due to increases in blood volume that naturally occur during pregnancy.

Chelation therapy

Those who receive blood transfusions to treat thalassemia typically use iron chelation therapy. The purpose of this is to prevent iron from building up in the body and causing health problems.

During pregnancy, you’ll likely be asked to stop using your chelation therapy medications as it’s unclear how some of them may affect your developing baby.

Some people may receive chelation therapy after 20 weeks of pregnancy if their iron levels become too high.

Blood clot prevention

Pregnancy also increases the risk of blood clots, and having thalassemia can make this risk even higher. As such, it’s possible that you may be prescribed low dose aspirin or heparin to help prevent blood clots from forming.

The anemia associated with thalassemia can increase the risk of intrauterine growth restriction (IUGR). This is when a baby’s fetal weight is below the tenth percentile for their gestational age.

Some of the maternal complications that can happen due to thalassemia in pregnancy include:

If you have thalassemia during your pregnancy, you may go on to have a healthy pregnancy. However, there’s a risk of several types of complications, particularly in those with transfusion-dependent thalassemia.

If you have thalassemia, it’s important to consult with your doctor prior to becoming pregnant. They can take your individual situation into account and give you a better idea of what to expect during a pregnancy.

What’s the life expectancy of a person with thalassemia?

The life expectancy for a person with thalassemia depends on how severe their condition is. Those with mild thalassemia generally have a longer life expectancy.

The life expectancy of individuals with transfusion-dependent thalassemia is shorter. About 80% of these individuals have a life expectancy of over 40 years.

Does thalassemia affect fertility?

Yes. Thalassemia can affect the levels of sex hormones, lowering fertility. Additionally, people with thalassemia may often have other conditions that affect fertility, such as hypothyroidism and diabetes.

What happens if a baby is born with thalassemia?

Babies with mild thalassemia may not need treatment. However, those with moderate to severe thalassemia may need treatment with blood transfusions and iron chelation therapy.

Having thalassemia can increase the risk of complications during pregnancy. However, many people with thalassemia can go on to have a healthy pregnancy with appropriate monitoring and care.

If you have thalassemia while pregnant, it will affect your treatment plan. Additionally, it’s important that you are in good overall health prior to becoming pregnant.

If you have thalassemia and would like to become pregnant, it’s important that you meet with your doctor prior to trying to conceive. They can assess your overall health and advise you on what to expect prior to and during a pregnancy.