Thalassemia and Pregnancy: What Every Mother-to-Be Should Know
Thalassemia and pregnancy: risks, monitoring, and prevention options explained by Dr. Najeeb Layyous.
In short: Thalassaemia is an inherited blood disorder affecting haemoglobin; the severe form appears when both parents carry the gene. Anaemia may worsen in pregnancy and require blood transfusion and treatment to remove excess iron, which can harm the heart, liver and glands, and the baby’s growth may be affected. Having an affected child can be avoided by IVF with genetic testing of the embryos.
Thalassemia is an inherited blood disease caused by a hemoglobin disorder (a hemoglobinopathy).
Thalassemia leads to chronic anemia, and the severity of this anemia depends on the degree of the underlying genetic defect.
What are the main principles of treatment for thalassemia patients?
- Blood transfusion
- Removing iron that accumulates in the organs
How does thalassemia affect pregnant women?
- Chronic anemia
- The need for blood transfusion and the risks associated with it
- Iron accumulation in the organs, which can affect how those organs function
How does thalassemia affect the baby?
- It may lead to restricted fetal growth
- The baby may inherit thalassemia from the parents
How are the mother’s organs affected by iron accumulation?
- Heart: heart muscle weakness (myocardial failure)
- Pancreas: diabetes
- Thyroid gland: underactive thyroid (hypothyroidism)
- Liver: cirrhosis and gallstone formation
- Bones: osteoporosis
How is thalassemia inherited?
Thalassemia is inherited in an autosomal recessive pattern, meaning a person needs to inherit two affected genes — one from each parent — for the severe form of the disease to appear.
A person who carries just one copy of the gene usually has only mild, chronic anemia.
Can thalassemia cause infertility?
Yes. Iron accumulation in the testicles or ovaries can damage these organs and affect their normal function.
How can parents who carry the thalassemia gene avoid passing the disease to their children?
Through in vitro fertilization (IVF) combined with genetic testing of the embryos before they are transferred to the uterus — allowing only unaffected embryos to be selected for pregnancy.
The first step is to test the partner. If both partners are carriers, IVF with embryo testing is one option; another is testing the baby during a natural pregnancy by chorionic villus sampling (from 11 weeks) or amniocentesis (from 15 weeks).
How is a pregnant woman with thalassemia followed up during pregnancy?
Before pregnancy, women with thalassemia major should have their heart, liver and iron levels checked (including an echocardiogram and MRI for iron), take a high dose of folic acid (5 mg daily) starting before conception, and review their iron-removal (chelation) medicines with their doctor, as some of them must be stopped before pregnancy.
- Regular monitoring of the baby’s growth
- Diabetes screening and follow-up
- Regular checks of thyroid function
- Monitoring of CBC (complete blood count) and iron stores
- Blood transfusion when needed
- Regular checks of blood type and antibodies
Should a pregnant woman with thalassemia be given blood-thinning medication?
This depends on the platelet count and whether the woman has had her spleen removed. Depending on these factors, your doctor may recommend aspirin alone, or aspirin combined with heparin injections.
Does a woman with thalassemia need to have a caesarean section?
Not necessarily — this depends on how the pregnancy progresses and other individual health factors.
It’s important to note that pregnant women with thalassemia are at higher risk of developing blood clots after giving birth, so preventive doses of heparin are usually recommended after delivery.
Can women with thalassemia breastfeed?
Yes, breastfeeding is generally possible for women with thalassemia.
If you have thalassemia and are planning a pregnancy, or are already pregnant, the team at Dr. Najeeb Layyous’s clinic can help guide you through personalized monitoring and care options — please reach out to discuss your situation.
Dr Najeeb Layyous F.R.C.O.G
Consultant Obstetrician, Gynecologist and Infertility Specialist
The finest doctor in Jordan — may God bless him and his whole medical team. A doctor in every sense of the word. I advise anyone planning a pregnancy to visit Dr. Najeeb Layyous. His manner is wonderful, always smiling, with the highest ethics; he gives every patient her due, and the patient’s comfort matters most to him. We had been to many doctors and none understood and treated my case except him. Special thanks to him and the whole team, and to Dina in particular — a lovely person. I recommend anyone considering IVF or pregnancy to visit his clinic.