Kai Sun Zhao,1,* Qiao Ai Pan,2,* Hong Yan Yang,2 Jun You Su,2 Li Deng2 

1Department of Obstetrics, The Second Nanning People’s Hospital (The Third Affiliated Hospital of Guangxi Medical University), Nanning, Guangxi, 530031, People’s Republic of China; 2Department of Obstetrics, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530007, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Li Deng; Junyou Su, Department of Obstetrics, The Second Affiliated Hospital of Guangxi Medical University, No. 166, Daxuedong Road, Xixiangtang District, Nanning, Guangxi Zhuang Autonomous Region, People’s Republic of China, Tel +86 13877105871 ; +86 15277199813, Email dengli@gxmu.edu.cn; sujunyou@sr.gxmu.edu.cn

Objective: The study aimed to provide clinical evidence regarding the perinatal management of HbH disease by comparing and analyzing blood routine, anemia characteristics, and their influence on pregnancy outcomes in patients with common deletional and non-deletional HbH disease at various pregnancy stages.
Patients and Methods: From May 2017 to October 2023, a comparative analysis was conducted on pregnant women undergoing treatment at the Second Affiliated Hospital of Guangxi Medical University and the Second Nanning People’s Hospital. The study included 42 cases of deletional HbB disease and 32 cases of non-deletional HbH disease. The study assessed blood routine, anemia, and pregnancy outcomes during early and late pregnancy.
Results: In the deletional group, there was a significantly higher incidence of moderate anemia during both early and late pregnancy compared to the non-deletional group. Moreover, the deletional group exhibited a significantly lower mean corpuscular volume (MCV) during early and late pregnancy and mean corpuscular hemoglobin (MCH) during late pregnancy, with statistically significant differences (p< 0.05) compared to the non-deletional group. Additionally, the non-deletional group had a significantly higher incidence of postpartum blood transfusion, fetal growth restriction (FGR), and low birth weight (LBW) compared to the deletional group, with a statistically significant difference (p< 0.05).
Conclusion: Pregnant patients with alpha-thalassemia HbH disease and non-deletional HbH disease commonly experience moderate anemia, increasing the risk of adverse pregnancy outcomes, particularly in non-deletional HbH disease cases where negative outcomes are more prevalent. It is crucial to enhance perinatal monitoring and intervention for pregnant women with HbH disease, including regular assessment of hemoglobin (Hb) levels, MCV, and MCH, and implementing measures to manage anemia to mitigate adverse pregnancy outcomes effectively.

Keywords: hemoglobin H disease, deletional HbH, non-deletional HbH, perinatal care, pregnancy outcomes