Risks during pregnancy

If a woman has thalassemia, what are the risks during pregnancy and birth?

I know of a woman in Cambodia who gave birth to a baby, not so long ago. The baby was born premature, and died two weeks after birth. I don't know if thalassemia was involved, but it is likely to have been.

If people were tested for thalassemia, and some were found to have it, would there be some women you would advise not to have babies? I suspect women with thalassemia major would be unwise to have children. Is that right? What about women with thalassemia intermedia?

I am not talking about the likelihood of children inheriting thalassemia. I am talking about the risks during pregnancy and birth, when the mother has thalassemia.

The main risks during pregnancy for thalassemics are clotting disorders, that can lead to miscarriage.
If it is alpha thalassemia of the major type, the baby usually does not survive to birth and if it does, dies shortly afterward. This may be the case with the woman you know, if thalassemia was involved in the death. Alpha thal is very common in Southeast Asia.

Beta thal majors can get pregnant, but for many majors, it is very difficult to get pregnant. When they do, the pregnancy does have to be closely monitored and extra transfusions given if required. Proper transfusions can reduce the risks during pregnancy. It does help to have a decent medical system for majors to have successful pregnancies. As long as the father is not a thal carrier, the children will all be thal minor.

Should thal women be advised to not have children? I do think any woman who is a thal major needs to be honest at what type of medical system they have available during the pregnancy and birth. If inadequate, I don't think the risks are worth it. Many majors do have children, but most I know who did had good medical care available.

Thanks for your feedback.

There may be things I don't know. But I think anyone in Cambodia with thalassemia major would not live long enough to have children. Blood transfusions are not widely available. I have never met anyone in Cambodia receiving blood transfusions for thalassemia major. There are probably none.

In some of the best hospitals, blood transfusions are available. I think only for emergency situations, not people who require regular transfusions for a long time. There is simply not enough blood donation for the majority of people with thalassemia major. Also many ordinary people don't go to these hospitals, but just go to a small hospital in their local area.

In places like Australia, where they have regular blood transfusions, they can live long enough to have children.

In places where blood transfusions are not widely available, probably people with thalassemia intermedia should be warned of the risks, maybe even those with thalassemia minor.