Changes in blood cell parameters and serum iron level in pregnant women with β-thalassemia and their diagnostic value

Zhou Zhenxiang; Zheng Kaixian; Zhong Yang

doi:10.3969/j.issn.1674-7151.2025.04.014

Abstract：Objective To explore the changes of blood cell parameters and serum iron(SI)level in pregnant women with β-thalassemia and the application value in differential diagnosis of the disease.Methods The 58 pregnant women with anemia who underwent regular prenatal examinations at Longyan People's Hospital from January to November 2024 were selected as research subjects.According to the type of anemia,the patients were divided into thalassemia group(24 cases)and iron deficiency anemia group(34 cases).The thalassemia group was further divided into β-thalassemia group(14 cases)and α-thalassemia group(10 cases).Additionally,82 healthy pregnant women who underwent prenatal examinations during the same period were selected as control group.All subjects were tested for peripheral blood cell parameters[mean corpuscular hemoglobin(MCH)and mean corpuscular volume(MCV)],SI and hemoglobin A2(HbA2)using blood cell analyzer and electrophoresis.The differences in levels of above indicators among pregnant women with different types of anemia were compared.Receiver operator characteristic curve(ROC curve)was drawn and area under ROC curve(AUC)was calculated to analyze the diagnostic value of MCH,MCV,SI and HbA2 alone and in combination for β-thalassemia in pregnant women.Results The levels of MCH and MCV in thalassemia group were lower than those in control group and iron deficiency anemia group[MCH(pg):21.52±3.13 vs.30.03±3.56,26.20±4.55;MCV(fL):68.11±6.28 vs.90.23±5.02,76.85±3.44;all P<0.05],and the levels of MCH and MCV in iron deficiency anemia group were lower than those in control group(all P<0.05).The levels of SI in thalassemia group and control group were higher than that in iron deficiency anemia group(μmol/L:19.12±4.33,18.35±5.57 vs.10.75±2.02,both P<0.05).The level of HbA2 in thalassemia group was significantly higher than those in control group and iron deficiency anemia group(0.031±0.010 vs.0.028±0.002,0.028±0.003,both P<0.05).The levels of MCH and MCV in β-thalassemia group were lower than those in α-thalassemia group,and the level of HbA2 was higher than that in α-thalassemia group[MCH(pg):20.15±2.42 vs.22.43±2.30;MCV(fL):67.06±2.94 vs.69.79±3.23;HbA2:0.039±0.006 vs.0.022±0.003;all P<0.05].The predictive efficacy of MCH,MCV,SI and HbA2 alone for β-thalassemia in pregnant women was relatively low,while the combined detection of MCH,MCV and SI had a higher predictive efficacy,with AUC of 0.707,sensitivity of 85.71%,and specificity of 56.82%.The combined detection of four indicators had the highest predictive efficacy for β-thalassemia in pregnant women,with AUC of 0.724,sensitivity of 92.86%,and specificity of 47.73%.Conclusions There are certain differences in MCH,MCV,SI and HbA2 levels among different types of pregnant women with thalassemia.The combined detection of MCH,MCV,SI and HbA2 is helpful for the diagnosis of β-thalassemia during pregnancy.The combined detection of MCH,MCV,SI and HbA2 has the highest diagnostic efficiency for β-thalassemia during pregnancy.