{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:12:15Z","timestamp":1773000735129,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":362,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anemia"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Thalassemia trait generally has minimal clinical impact, but physiologic changes during pregnancy may increase the risk of anemia, transfusion requirements, and hypertensive disorders. Existing evidence on pregnancy outcomes in this population is limited, with some conflicting data. This study aims to evaluate pregnancy\u2010related outcomes in patients with thalassemia trait using a large, multicenter database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      For this retrospective cohort study, we used data from the TriNetX US Collaborative Network. Females aged 18\u201345 with ICD\u201010 codes indicating pregnancy (Z33.1, O00\u2013O9A, Z34, or Z3A) were included. Patients with pregnancy and coexisting thalassemia trait (D56.3) were assigned to the thalassemia cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922,913), while those without any thalassemia diagnosis comprised the nonthalassemia cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095,611,147). Propensity score matching was performed to balance age, race\/ethnicity, obesity, smoking status, essential hypertension, and Type 2 diabetes mellitus. After 1:1 matching, 22,770 patients remained in each cohort (total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200945,540). Outcomes were assessed within 1\u2009year of the index date, including anemia during pregnancy, blood transfusion, preeclampsia\/eclampsia, cesarean delivery, venous thromboembolism (VTE), heart failure\/cardiomyopathy, preterm delivery, intrauterine growth restriction (IUGR), and intrauterine fetal demise (IUFD). Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thalassemia trait was associated with higher risks of anemia during pregnancy (RR: 3.00 and 95% CI: 2.87\u20133.13), needing blood transfusion (RR: 1.90 and 95% CI: 1.69\u20132.20), preeclampsia\/eclampsia (RR: 1.54 and 95% CI: 1.47\u20131.61), cesarean delivery (RR: 1.43 and 95% CI: 1.36\u20131.51), preterm delivery &lt; 37\u2009weeks (RR: 1.40 and 95% CI: 1.31\u20131.65), and IUGR (RR: 1.96 and 95% CI: 1.72\u20132.23), all were statistically significant with a\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001. Increased risk was also observed for VTE (RR: 1.57 and 95% CI: 1.12\u20132.20,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and IUFD (RR: 1.37 and 95% CI: 1.087\u20131.75,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). No significant association was found with heart failure\/cardiomyopathy (RR: 1.28 and 95% CI: 0.93\u20131.76,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.124).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thalassemia trait in pregnancy was associated with increased rates of anemia, transfusion, and adverse maternal and fetal outcomes. Such adverse outcomes include pre\u2010eclampsia\/eclampsia, cesarean delivery, preterm birth and IUGR. These findings underscore the need for tailored peripartum care strategies in this high\u2010risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/anem\/8899690","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T06:47:16Z","timestamp":1767077236000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pregnancy Outcomes in Women With Thalassemia Trait: A Multicenter Cohort Study"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0235-9116","authenticated-orcid":false,"given":"Daria","family":"Chelysheva","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3340-6736","authenticated-orcid":false,"given":"Ameera","family":"Syed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9005-2143","authenticated-orcid":false,"given":"Hannah","family":"Ruby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9824-7828","authenticated-orcid":false,"given":"Anna","family":"Homeniuk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2573-3454","authenticated-orcid":false,"given":"Anas","family":"Atrash","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2751-3783","authenticated-orcid":false,"given":"Feras Al","family":"Moussally","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_2_13_1_2","volume-title":"Guidelines for the Management of Transfusion Dependent Thalassemia","author":"Cappellini M. D.","year":"2020"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102619"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/03630269.2024.2446360"},{"key":"e_1_2_13_4_2","volume-title":"Williams Obstetrics","author":"Cunningham F. G.","year":"2018"},{"key":"e_1_2_13_5_2","volume-title":"Thromboembolism in Pregnancy (Practice Bulletin No. 196)","author":"American College of Obstetricians and Gynecologists","year":"2018"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000126575.34482.fb"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829b2be"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3908-6"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06519-y"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-03-0807"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S89308"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19051496"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2886-9"},{"key":"e_1_2_13_14_2","first-page":"9","article-title":"The Pregnancy Outcome in Patients With Minor \u03b2-Thalassemia","volume":"9","author":"Amooee S.","year":"2011","journal-title":"Iranian Journal of Reproductive Medicine"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.4084\/MJHID.2019.019"},{"key":"e_1_2_13_16_2","volume-title":"Reducing the Risk of Venous Thromboembolism During Pregnancy and the Puerperium (Green-Top Guideline No. 37a)","author":"Royal College of Obstetricians and Gynaecologists","year":"2015"}],"container-title":["Anemia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/anem\/8899690","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/anem\/8899690","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/anem\/8899690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:44:44Z","timestamp":1772991884000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/anem\/8899690"}},"subtitle":[],"editor":[{"given":"Duran","family":"Canatan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/anem\/8899690"],"URL":"https:\/\/doi.org\/10.1155\/anem\/8899690","archive":["Portico"],"relation":{},"ISSN":["2090-1267","2090-1275"],"issn-type":[{"value":"2090-1267","type":"print"},{"value":"2090-1275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8899690"}}