Thalassemia Pregnancy and Thalassemia
How does thalassemia affect pregnancy?
Thalassemia may affect your ability to become pregnant, especially if you have a moderate or serious type of thalassemia. It may also lead to a higher chance of health risks during pregnancy. There are many things you can do to minimize risks and ensure that you and your baby are safe and healthy.
Before you and your partner conceive a child, you should meet with your healthcare provider to discuss your plans. Thalassemia is an inherited condition, which means you can pass it on to your baby. You may want to meet with a genetic counselor, who can answer questions about the risk and explain the choices that are available.
Depending on several factors, your healthcare provider may want to do one or more of the tests below.
- Genetics: Because thalassemia is an inherited disorder, meaning it is passed from parent to child through , your partner should be screened to see whether they carry any faulty genes related to thalassemia. If both you and your partner carry a faulty gene for thalassemia, your healthcare provider may screen your baby for thalassemia before birth.
- Iron levels: You may have high iron levels due to regular blood transfusions. High levels of iron can be dangerous during pregnancy. Your healthcare provider may use MRI to measure iron levels in your organs, including your liver and heart.
- Heart and liver function: Your provider may run heart tests, such as an electrocardiogram (ECG or EKG) or echocardiogram, or they may ask you to wear a Holter or event monitor. To look at your liver, your provider may use an or MRI to check for liver disease (fibrosis).
- Bone mineral density: Since weak bones caused by osteoporosis are a complication of thalassemia, your healthcare provider may run a test to measure your bone density. These tests are typically done using a dual-energy X-ray absorptiometry (DEXA).
- Infections: Many viruses can lead to severe health risks during pregnancy. Your provider may test you for certain viral infections, such as hepatitis B, hepatitis C, HIV, cytomegalovirus, and human parvovirus B19. They will also recommend that you stay up-to-date on routine vaccinations.
- Thyroid function: Thalassemia can cause your thyroid to produce too little thyroid hormone. This can make it difficult to become pregnant. Your healthcare provider can measure your levels of thyroid hormone using a blood test.
Thalassemia and iron overload associated with treatment can cause problems with fertility for both men and women. Fertility is the ability to conceive a child. Talk to your healthcare provider if you are having difficulty getting pregnant with your partner. Your provider may refer you to a doctor who specializes in fertility. This specialist can work with you to make a plan that will work best for you and your family.
If you have thalassemia and become pregnant, you will need to see your healthcare provider for checkups frequently — each month for the first two trimesters (28 weeks) and then every 2 weeks toward the end of your pregnancy.
Your provider may want to run more tests to check your heart, liver, or thyroid function. Your provider will also screen you for gestational diabetes at 16 weeks, and may repeat the screening at 28 weeks, depending on the results of the first test. Finally, you may need to stop taking or switch your iron chelation medicine if you require blood transfusions throughout your pregnancy as part of your treatment.
Your provider will also monitor your baby’s health and can test your baby for thalassemia. If your baby has a serious form of thalassemia, they may need a blood transfusion before birth to treat fetal anemia and prevent life-threatening health problems after birth.
Taking precautions can help lower your risk for pregnancy complications, but they can still happen. Pregnancy complications include:
- Gestational diabetes
- High blood pressure (gestational hypertension)
- Kidney or gallbladder stones
- Placental abruption, which happens when the separates from the uterus before birth
- Urinary tract infection (UTI)
While not common, heart problems during pregnancy can happen and can be life-threatening. Talk to your provider about steps you can take to help your heart during and after pregnancy.