广西南宁地区地中海贫血孕妇基因型分布及其对妊娠结局的影响

doi:10.3969/j.issn.1674-8115.2026.05.008

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (5): 624-632.doi: 10.3969/j.issn.1674-8115.2026.05.008

• 论著 · 临床研究 • 上一篇

广西南宁地区地中海贫血孕妇基因型分布及其对妊娠结局的影响

李静, 梁旭霞, 邬华, 张春, 卢燕群, 张继红()

广西医学科学院/广西壮族自治区人民医院产科，南宁 530021

收稿日期:2025-08-19 接受日期:2025-12-25 出版日期:2026-05-28 发布日期:2026-05-28
通讯作者: 张继红，主任医师，硕士；电子信箱：649588561@qq.com。
基金资助:
广西科技计划项目(桂科AB22035018);广西医疗卫生适宜技术开发与推广应用项目(S2022021);广西壮族自治区卫生健康委员会科技研究计划项目(Z20210594)

Genotypic distribution of thalassemia in pregnant women in Nanning, Guangxi, and its impact on pregnancy outcomes

Li Jing, Liang Xuxia, Wu Hua, Zhang Chun, Lu Yanqun, Zhang Jihong()

Department of Obstetrics, Guangxi Academy of Medical Science/The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China

Received:2025-08-19 Accepted:2025-12-25 Online:2026-05-28 Published:2026-05-28
Contact: Zhang Jihong, E-mail: 649588561@qq.com.
Supported by:
Guangxi Science and Technology Program Project(桂科AB22035018);Guangxi Healthcare Appropriate Technology Development and Promotion Project(S2022021);Scientific Research Program of Guangxi Zhuang Autonomous Region Health Commission(Z20210594)

摘要/Abstract

摘要：

目的·探讨广西南宁地区地中海贫血（简称地贫）孕妇的基因型分布特征及其对妊娠结局的影响。方法·采用回顾性队列研究设计，纳入2021年1月至2024年12月在广西壮族自治区人民医院建档的3 649例孕妇，根据地贫基因诊断结果分为α地贫（1 296例）、β地贫（505例）、α复合β地贫（100例）及正常孕妇（1 748例）。比较各组血液学参数包括平均红细胞体积（mean corpuscular volume，MCV）、平均红细胞血红蛋白含量（mean corpuscular hemoglobin，MCH）、血红蛋白（hemoglobin，Hb）水平、HbA₂水平，以及妊娠结局包括低出生体质量儿（low birth weight，LBW）、早产等；采用多因素Logistic回归分析地贫基因型与不良妊娠结局的关联。通过受试者操作特征（receiver operating characteristic，ROC）曲线确定MCV和HbA₂预测α复合β地贫的最佳截断值。结果·α地贫以--^SEA/αα（50.62%）为主，β地贫以βCD41-42/β^N（46.93%）为主，α复合β地贫以--^SEA/αα复合βCD17/β^N（12.00%）为主。β地贫组MCV、MCH、Hb水平显著低于其他组（均P<0.001），β地贫组和α复合β地贫组HbA₂均显著高于正常组和α地贫组（均P<0.001）。α复合β地贫孕妇的MCV截断值为74.95 fL（AUC=0.788），HbA₂截断值为3.35%（AUC=0.867）。β地贫是子代LBW的独立危险因素（aOR=1.785，95%CI 1.051⁓3.031，P=0.032）；而在未调整混杂因素前，α复合β地贫组表现出最高的LBW风险（OR=2.592，95%CI 1.368⁓4.912，P=0.004）。结论·广西南宁地区地贫孕妇基因型分布具有地域特征，β地贫和α复合β地贫显著增加子代LBW风险；可对MCV≤74.95 fL且HbA₂≥3.35%的孕妇联合进行α和β地贫基因检测，并将β地贫孕妇列为LBW高危人群加强监测。

关键词: 地中海贫血, 基因型, 妊娠结局, 队列研究

Abstract:

Objective ·To investigate the genotypic distribution of thalassemia in pregnant women in Nanning, Guangxi, and its impact on pregnancy outcomes. Methods ·A retrospective cohort study was conducted among 3 649 pregnant women enrolled from January 2021 to December 2024 at the Guangxi Zhuang Autonomous Region People′s Hospital. Participants were categorized into α-thalassemia (n=1 296), β-thalassemia (n=505), α-composite β- thalassemia (n=100), and normal controls (n=1 748) based on genetic diagnosis. Hematological parameters, including mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin (Hb), and HbA₂, as well as pregnancy outcomes such as low birth weight (LBW) and preterm birth, were compared among the groups. Multivariate Logistic regression was used to analyze the association between thalassemia genotypes and adverse outcomes. The optimal cut-off values of MCV and HbA₂ for predicting α-composite β-thalassemia were determined using receiver operating characteristic (ROC) curve analysis. Results ·The predominant genotypes were --^SEA/αα (50.62%) in α-thalassemia, βCD41-42/β^N (46.93%) in β-thalassemia, and --^SEA/αα combined with βCD17/β^N (12.00%) in α-composite β-thalassemia. The levels of MCV, MCH, and Hb in the β-thalassemia group were significantly lower than those in the other groups (all P<0.001), while the HbA₂ levels in the β-thalassemia group and the α-composite β-thalassemia group were significantly higher than those in the normal and α-thalassemia groups. The optimal cut-off values for predicting α-composite β-thalassemia were MCV ≤74.95 fL (AUC=0.788) and HbA₂ ≥3.35% (AUC=0.867). β-thalassemia was an independent risk factor for LBW in offspring (aOR=1.785, 95%CI 1.051‒3.031, P=0.032). However, before adjustment for confounding factors, the α-composite β-thalassemia group exhibited the highest risk of LBW (OR=2.592, 95%CI 1.368‒4.912, P=0.004). Conclusion ·Thalassemia genotypes in pregnant women in Nanning, Guangxi, exhibit distinct regional patterns, with β-thalassemia and α-composite β-thalassemia significantly increasing LBW risk. Combined α- and β-thalassemia genetic testing is recommended for pregnant women with MCV ≤74.95 fL and HbA₂≥3.35%, and those with β-thalassemia should be monitored as a high-risk group for LBW.

Key words: thalassemia, genotype, pregnancy outcome, cohort study

中图分类号:

R714.2

李静, 梁旭霞, 邬华, 张春, 卢燕群, 张继红. 广西南宁地区地中海贫血孕妇基因型分布及其对妊娠结局的影响[J]. 上海交通大学学报（医学版）, 2026, 46(5): 624-632.

Li Jing, Liang Xuxia, Wu Hua, Zhang Chun, Lu Yanqun, Zhang Jihong. Genotypic distribution of thalassemia in pregnant women in Nanning, Guangxi, and its impact on pregnancy outcomes[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(5): 624-632.

图/表 7

参考文献 27

[1]	Tariq Z, Qadeer M I, Anjum I, et al. Thalassemia and nanotheragnostics: advanced approaches for diagnosis and treatment[J]. Biosensors, 2023, 13(4): 450.
[2]	Wang W D, Hu F, Zhou D H, et al. Thalassaemia in China[J]. Blood Rev, 2023, 60: 101074.
[3]	Tsamantioti E, Alfvén T, Hossin M Z, et al. Maternal anaemia and risk of neonatal and infant mortality in low- and middle-income countries: a secondary analysis of 45 national datasets[J]. BMJ Glob Health, 2025, 10(3): e014654.
[4]	Igbinosa I I, Leonard S A, Noelette F, et al. Racial and ethnic disparities in anemia and severe maternal morbidity[J]. Obstet Gynecol, 2023, 142(4): 845-854.
[5]	Ohuma E O, Jabin N, Young M F, et al. Association between maternal haemoglobin concentrations and maternal and neonatal outcomes: the prospective, observational, multinational, INTERBIO-21st fetal study[J]. Lancet Haematol, 2023, 10(9): e756-e766.
[6]	Wedderburn C J, Ringshaw J E, Donald K A, et al. Association of maternal and child anemia with brain structure in early life in South Africa[J]. JAMA Netw Open, 2022, 5(12): e2244772.
[7]	Vlachodimitropoulou E, Mogharbel H, Kuo K H M, et al. Pregnancy outcomes and iron status in β-thalassemia major and intermedia: a systematic review and meta-analysis[J]. Blood Adv, 2024, 8(3): 746-757.
[8]	Torti L. Life beyond alpha-thalassaemia: we are moving forward[J]. Br J Haematol, 2022, 199(1): 11-13.
[9]	Teawtrakul N, Jetsrisuparb A, Pongudom S, et al. Survival and thalassaemia-related complications in HbE/β-thalassaemia and α-thalassaemia: a 10-year longitudinal study in Thailand[J]. Br J Haematol, 2025, 207(2): 552-560.
[10]	中华医学会围产医学分会, 中华医学会妇产科学分会产科学组. 地中海贫血妊娠期管理专家共识[J]. 中华围产医学杂志, 2020, 23(9): 577-584.
	Society of Perinatal Medicine, Chinese Medical Association, Obstetric Subgroup, Society of Obstetrics and Gynecology, Chinese Medical Association. Expert consensus on management of thalassemia in pregnancy[J]. Chinese Journal of Perinatal Medicine, 2020, 23(9): 577-584.
[11]	Langer A L, Goggins B B, Esrick E B, et al. β-Thalassemia minor is associated with high rates of worsening anemia in pregnancy[J]. Blood, 2025, 145(6): 648-651.
[12]	Musallam K M, Lombard L, Kistler K D, et al. Epidemiology of clinically significant forms of α- and β-thalassemia: a global map of evidence and gaps[J]. Am J Hematol, 2023, 98(9): 1436-1451.
[13]	World Health Organization. Anaemia in women and children[EB/OL]. (2019-01-08)[2025-10-07]. https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children.
[14]	Fan H, Kouvari M, Guo C N, et al. A comprehensive comparison of two commonly used BMI thresholds for non-communicable diseases and multimorbidity in the Chinese population[J]. Clin Nutr, 2025, 48: 70-79.
[15]	Singh M, Wambua S, Lee S I, et al. Autoimmune diseases and adverse pregnancy outcomes: an umbrella review[J]. BMC Med, 2024, 22(1): 94.
[16]	Lawn J E, Ohuma E O, Bradley E, et al. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting[J]. Lancet, 2023, 401(10389): 1707-1719.
[17]	孔北华, 马丁, 段涛, 等. 妇产科学[M]. 10版. 北京: 人民卫生出版社, 2024.
	Kong B H, Ma D, Duan T. Obstetrics and gynecology[M]. 10th ed. Beijing: People′s Medical Publishing House, 2024.
[18]	Cai A Q, Liu X H, Ma Q W, et al. Prevalence, mutation distribution, and economic burden of thalassemia in China: a systematic review and regional analysis[J]. Arch Public Health, 2025, 83(1): 92.
[19]	Yu Y, Lu C J, Gao Y, et al. Molecular spectrum, ethnic and geographical distribution of thalassemia in the southern area of Hainan, China[J]. Front Pediatr, 2022, 10: 894444.
[20]	Zhu J Q, Li H Z, Aerbajinai W, et al. Kruppel-like factor 1-GATA1 fusion protein improves the sickle cell disease phenotype in mice both in vitro and in vivo[J]. Blood, 2022, 140(21): 2276-2289.
[21]	Gambari R, Finotti A. Therapeutic relevance of inducing autophagy in β-thalassemia[J]. Cells, 2024, 13(11): 918.
[22]	Song M Y, Wei X L, Luo H L, et al. A common TBP-binding site mutation elevates fetal hemoglobin levels by competitive globin switching change in β-thalassemia[J]. Blood Adv, 2025, 9(13): 3159-3169.
[23]	Musallam K M, Cappellini M D, Coates T D, et al. α-thalassemia: a practical overview[J]. Blood Rev, 2024, 64: 101165.
[24]	Wake M, Palin A, Belot A, et al. A human anti-matriptase-2 antibody limits iron overload, α-globin aggregates, and splenomegaly in β-thalassemic mice[J]. Blood Adv, 2024, 8(8): 1898-1907.
[25]	Yu Y, Woloshun R R, Lee J K, et al. Fetal factors disrupt placental and maternal iron homeostasis in murine β-thalassemia[J]. Blood, 2023, 142(2): 185-196.
[26]	王金梅, 郑琳. 轻型地中海贫血孕妇孕晚期血液特点及妊娠结局[J]. 中国计划生育学杂志, 2021, 29(10): 2162-2165.
	Wang J M, Zheng L. Blood characteristics of women with mild thalassemia during the third trimester of pregnancy and their influence on pregnancy outcomes[J]. Chinese Journal of Family Planning, 2021, 29(10): 2162-2165.
[27]	Lal A, Viprakasit V, Vichinsky E, et al. Disease burden, management strategies, and unmet needs in α-thalassemia due to hemoglobin H disease[J]. Am J Hematol, 2024, 99(11): 2164-2177.

Item	Normal group (n=1 748)	Thalassemia group (n=1 901)	t/χ²	P value
Age/year	31.47±4.40	31.04±4.45	2.92	0.004
Age group/n(%)			2.88	0.103
≥35 years	422(24.14)	414(21.78)
<35 years	1 326(75.86)	1 487(78.22)
Ethnicity/n(%)			24.59	<0.001
Han	961(54.98)	925(48.66)
Zhuang	692(39.59)	902(47.45)
Others	95(5.43)	74(3.89)
Pre-pregnancy BMI/(kg·m^-2)	21.94±3.06	21.80±2.94	1.40	0.162
Pre-pregnancy BMI group/n(%)			6.22	0.111
<18.5 kg·m^-2	193(11.04)	208(10.94)
18.5‒23.9 kg·m^-2	1 146(65.56)	1 311(68.96)
24.0‒27.9 kg·m^-2	339(19.39)	314(16.52)
≥28.0 kg·m^-2	70(4.00)	68(3.58)
Educational attainment/n(%)			3.75	0.290
Postgraduate and above	141(8.07)	131(6.89)
University	1 310(74.94)	1 415(74.43)
High school	97(5.55)	106(5.58)
Junior high school or less	200(11.44)	249(13.10)
Marital status/n(%)			0.80	0.669
Married	1 593(91.13)	1 724(90.69)
Unmarried	138(7.89)	162(8.52)
Divorced	17(0.97)	15(0.79)
Occupation/n(%)			6.07	0.057
Service industry	814(46.57)	812(42.71)
Professional staff	575(32.89)	652(34.30)
Unemployed	359(20.54)	437(22.99)
Parity/n(%)			1.31	0.536
0	953(54.52)	1 072(56.39)
1	718(41.08)	747(39.30)
≥2	77(4.41)	82(4.31)
ART/n(%)	163(9.32)	182(9.57)	0.07	0.821
Twins/n(%)	55(3.15)	69(3.63)	0.65	0.480
Smoking and alcohol drinking/n(%)	36(2.06)	44(2.31)	0.26	0.607
Medical history/n(%)
Diabetes mellitus	10(0.57)	9(0.47)	0.17	0.821
Chronic hypertension	14(0.80)	9(0.47)	1.56	0.316
PCOS	5(0.29)	4(0.21)		0.745
Heart disease	5(0.29)	4(0.21)		0.745
Autoimmune disease	8(0.46)	10(0.53)	0.09	0.820
Thyroid function/n(%)			0.30	0.857
Hyperthyroidism	51(2.92)	53(2.79)
Hypothyroidism	31(1.77)	38(2.00)
Family history of diabetes/n(%)	97(5.55)	82(4.31)	2.98	0.103
Anemia in first trimester/n(%)	157(8.98)	304(15.99)	39.91	<0.001
Degree of anemia/n(%)			19.86	<0.001
Mild	122(6.98)	215(11.31)
Moderate	35(2.00)	89(4.68)

Item	Normal group (n=1 748)	Thalassemia group (n=1 901)	t/χ²	P value
Age/year	31.47±4.40	31.04±4.45	2.92	0.004
Age group/n(%)			2.88	0.103
≥35 years	422(24.14)	414(21.78)
<35 years	1 326(75.86)	1 487(78.22)
Ethnicity/n(%)			24.59	<0.001
Han	961(54.98)	925(48.66)
Zhuang	692(39.59)	902(47.45)
Others	95(5.43)	74(3.89)
Pre-pregnancy BMI/(kg·m^-2)	21.94±3.06	21.80±2.94	1.40	0.162
Pre-pregnancy BMI group/n(%)			6.22	0.111
<18.5 kg·m^-2	193(11.04)	208(10.94)
18.5‒23.9 kg·m^-2	1 146(65.56)	1 311(68.96)
24.0‒27.9 kg·m^-2	339(19.39)	314(16.52)
≥28.0 kg·m^-2	70(4.00)	68(3.58)
Educational attainment/n(%)			3.75	0.290
Postgraduate and above	141(8.07)	131(6.89)
University	1 310(74.94)	1 415(74.43)
High school	97(5.55)	106(5.58)
Junior high school or less	200(11.44)	249(13.10)
Marital status/n(%)			0.80	0.669
Married	1 593(91.13)	1 724(90.69)
Unmarried	138(7.89)	162(8.52)
Divorced	17(0.97)	15(0.79)
Occupation/n(%)			6.07	0.057
Service industry	814(46.57)	812(42.71)
Professional staff	575(32.89)	652(34.30)
Unemployed	359(20.54)	437(22.99)
Parity/n(%)			1.31	0.536
0	953(54.52)	1 072(56.39)
1	718(41.08)	747(39.30)
≥2	77(4.41)	82(4.31)
ART/n(%)	163(9.32)	182(9.57)	0.07	0.821
Twins/n(%)	55(3.15)	69(3.63)	0.65	0.480
Smoking and alcohol drinking/n(%)	36(2.06)	44(2.31)	0.26	0.607
Medical history/n(%)
Diabetes mellitus	10(0.57)	9(0.47)	0.17	0.821
Chronic hypertension	14(0.80)	9(0.47)	1.56	0.316
PCOS	5(0.29)	4(0.21)		0.745
Heart disease	5(0.29)	4(0.21)		0.745
Autoimmune disease	8(0.46)	10(0.53)	0.09	0.820
Thyroid function/n(%)			0.30	0.857
Hyperthyroidism	51(2.92)	53(2.79)
Hypothyroidism	31(1.77)	38(2.00)
Family history of diabetes/n(%)	97(5.55)	82(4.31)	2.98	0.103
Anemia in first trimester/n(%)	157(8.98)	304(15.99)	39.91	<0.001
Degree of anemia/n(%)			19.86	<0.001
Mild	122(6.98)	215(11.31)
Moderate	35(2.00)	89(4.68)

Type	n(%)
α-thalassemia (n=1 296)
--^SEA/αα	656(50.62)
-α^3.7/αα	258(19.91)
α^CSα/αα	117(9.03)
-α^4.2/αα	104(8.02)
α^WSα/αα	77(5.94)
α^QSα/αα	17(1.31)
--^SEA/αα^WS	12(0.93)
--^SEA/-α^3.7	10(0.77)
--^THAI/αα	9(0.69)
-α^3.7/αα^WS	6(0.46)
-α^4.2/αα^WS	6(0.46)
--^SEA/-α^4.2	5(0.39)
-α^3.7/-α^4.2	5(0.39)
--^SEA/αα^CS	4(0.31)
-α^3.7/-α^3.7	4(0.31)
-α^4.2/-α^4.2	2(0.15)
α^CSα/αα^WS	2(0.15)
-α^3.7/αα^QS	1(0.08)
-α^3.7/αα^CS	1(0.08)
β-thalassemia (n=505)
βCD41-42/β^N	237(46.93)
βCD17/β^N	119(23.56)
-β28/β^N	42(8.32)
βIVS-II-654/β^N	41(8.12)
βE/β^N	27(5.35)
βCD71-72/β^N	16(3.17)
βIVS-I-1/β^N	14(2.77)
-β29/β^N	4(0.79)
βCD43/β^N	3(0.59)
βCD27-28/β^N	1(0.20)
-β30/β^N	1(0.20)

Type	n(%)
α-thalassemia (n=1 296)
--^SEA/αα	656(50.62)
-α^3.7/αα	258(19.91)
α^CSα/αα	117(9.03)
-α^4.2/αα	104(8.02)
α^WSα/αα	77(5.94)
α^QSα/αα	17(1.31)
--^SEA/αα^WS	12(0.93)
--^SEA/-α^3.7	10(0.77)
--^THAI/αα	9(0.69)
-α^3.7/αα^WS	6(0.46)
-α^4.2/αα^WS	6(0.46)
--^SEA/-α^4.2	5(0.39)
-α^3.7/-α^4.2	5(0.39)
--^SEA/αα^CS	4(0.31)
-α^3.7/-α^3.7	4(0.31)
-α^4.2/-α^4.2	2(0.15)
α^CSα/αα^WS	2(0.15)
-α^3.7/αα^QS	1(0.08)
-α^3.7/αα^CS	1(0.08)
β-thalassemia (n=505)
βCD41-42/β^N	237(46.93)
βCD17/β^N	119(23.56)
-β28/β^N	42(8.32)
βIVS-II-654/β^N	41(8.12)
βE/β^N	27(5.35)
βCD71-72/β^N	16(3.17)
βIVS-I-1/β^N	14(2.77)
-β29/β^N	4(0.79)
βCD43/β^N	3(0.59)
βCD27-28/β^N	1(0.20)
-β30/β^N	1(0.20)

Item	Normal (n=1 748)	α-thalassemia (n=1 296)	α-composite β-thalassemia (n=100)	β-thalassemia (n=505)	H	P value
MCV/fL	87.60(83.90‒90.50)	71.85(67.40‒80.83)	67.50(64.35‒71.05)	63.60(61.50‒66.10)^①	2 218.70	<0.001
MCH/pg	29.80(28.40‒30.90)	22.80(21.20‒26.70)	21.65(20.38‒22.80)	20.20(19.50‒21.20)^①	2 226.32	<0.001
Hb/(g·L^-1)	126.00(118.00‒132.00)	117.00(110.00‒124.00)	113.00(104.75‒120.00)	106.00(99.00‒113.00)^①	1 007.41	<0.001
HbA₂/%	2.60(2.40‒2.76)	2.45(2.30‒2.76)^③	5.00(2.76‒5.40)^②	5.20(2.76‒5.50)^②	1 184.40	<0.001

广西南宁地区地中海贫血孕妇基因型分布及其对妊娠结局的影响

Genotypic distribution of thalassemia in pregnant women in Nanning, Guangxi, and its impact on pregnancy outcomes

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 7

参考文献 27

相关文章 15

编辑推荐

Metrics

Parameter	Cut-off value	95%CI	Sensitivity/%	Specificity/%	Youden′s index	PPV/%	NPV/%	P value
MCV	74.95 fL	0.765‒0.821	94.00	63.62	0.576	6.79	99.73	<0.001
MCH	24.95 pg	0.746‒0.800	96.00	61.00	0.570	6.49	99.82	<0.001
Hb	123.50 g·L^-1	0.623‒0.711	90.00	39.17	0.292	4.00	99.29	<0.001
HbA₂	3.35%	0.842‒0.892	74.00	88.64	0.626	0.82	84.49	<0.001
Combined model	0.02	0.765‒0.821	94.00	63.62	0.576	0.27	93.21	<0.001

Outcome	Normal (n=1 748)	α-thalassemia (n=1 296)	α-composite β-thalassemia (n=100)	β-thalassemia (n=505)	F/χ²	P value
Maternal outcome
GDM/n(%)	346(19.79)	232(17.90)	15(15.00)	102(20.20)	3.23	0.372
HDP/n(%)	35(2.00)	14(1.08)	1(1.00)	6(1.19)	4.89	0.182
Anemia in 3rd trimester/n(%)	163(9.32)^②③④	303(23.38)^①④	34(34.00)^①④	330(65.35)^①②③	708.23	<0.001
Degree of anemia/n(%)					308.36	<0.001
Mild	119(6.81)^②③④	226(17.44) ^①④	20(20.00)^①④	193(38.22)^①②③
Moderate	44(2.52)^②③④	77(5.94)^①③④	14(14.00)^①②④	137(27.13)^①②③
GA at deliver/week	39.11±1.29^③	39.05±1.24	38.77±1.38^①④	39.16±1.08^③	3.29	0.020
Model of delivery/n(%)					9.97	0.127
Cesarean section	654(37.41)	480(37.04)	51(51.00)	181(35.84)
Vaginal delivery	1 026(58.70)	754(58.18)	46(46.00)	301(59.60)
Operative vaginal delivery	68(3.89)	62(4.78)	3(3.00)	23(4.55)
Neonatal ouctcome
Length/cm	50.05±1.98	50.11±2.10	49.66±2.22	50.07±1.87	1.76	0.153
Weight/g	3 162.02±417.95^③	3 155.14±433.56^③	3 046.94±446.80^①②	3 129.74±414.63	3.05	0.027
Sex/n(%)					0.67	0.882
Female	833(46.18)	618(46.19)	46(42.9)	237(45.23)
Male	971(53.82)	720(53.81)	62(57.41)	287(54.77)
Preterm birth/n(%)	72(3.99)	58(4.33)	7(6.48)	10(1.91)	8.19	0.051
LBW/n(%)	83(4.60)^③	77(5.75) ^③	12(11.11)^①②	34(6.49)	10.56	0.022
SGA/n(%)	208(11.53)	152(11.36)	15(13.89)	70(13.36)	2.05	0.585
Acidosis/n(%)	8(0.44)	6(0.45)	1(0.93)	4(0.76)	1.30	0.746
Neonatal asphyxia/n(%)	26(1.44)	11(0.82)	0(0)	4(0.76)	4.68	0.204

Group	Unadjusted model			Adjusted model
Group	OR	95%CI	P value	aOR	95%CI	P value
Normal group (ref.)	1.000			1.000
α-thalassemia	1.266	0.921‒1.741	0.146	1.310	0.900‒1.908	0.159
α-composite β-thalassemia	2.592	1.368‒4.912	0.004	2.123	0.963‒4.682	0.062
β-thalassemia	1.439	0.953‒2.171	0.083	1.785	1.051‒3.031	0.032

[1]	应奕雯, 李舒, 张珍, 虞靖然, 张宁, 牟姗. 高危妊娠人群妊娠相关急性肾损伤的临床特征和妊娠结局分析[J]. 上海交通大学学报（医学版）, 2026, 46(1): 60-65.
[2]	高欣洁, 刘艳, 王大威. 地中海贫血基因治疗研究进展及思考[J]. 上海交通大学学报（医学版）, 2025, 45(5): 540-548.
[3]	糜小扬, 丁莹, 陈奕静, 贾洁. 孕期超加工食品摄入与妊娠结局关系的研究进展[J]. 上海交通大学学报（医学版）, 2025, 45(1): 113-121.
[4]	马瑞琳, 刘雨, 徐桂香, 史昊然, 崔俭俭, 杨泽俊, 毛艳, 赵茵. 子痫前期大鼠模型子宫动脉、脐动脉、大脑中动脉超声多普勒参数与胎盘血管病理及妊娠结局的关系[J]. 上海交通大学学报（医学版）, 2024, 44(5): 543-551.
[5]	李玉, 张羽. 慢性肾脏病患者不良妊娠结局的危险因素分析[J]. 上海交通大学学报（医学版）, 2024, 44(5): 560-566.
[6]	黄勤, 黄缨, 李文. 输卵管复合妊娠的超声检查时间探讨[J]. 上海交通大学学报（医学版）, 2024, 44(12): 1545-1551.
[7]	张彤, 田雪, 左颖婷, 郑曼琪, 张怡君, 吴寿岭, 陈朔华, 马高亭, 佟旭, 王安心, 莫大鹏. 无传统危险因素人群中TyG指数与心脑血管疾病的关系[J]. 上海交通大学学报（医学版）, 2022, 42(3): 267-274.
[8]	李可可, 陈朝霖, 冯莹, 肖扬. 遗传性凝血因子Ⅴ缺乏基因型和表型的关联研究[J]. 上海交通大学学报(医学版), 2021, 41(8): 1074-1080.
[9]	曾金妹, 陈日玲, 何洁云, 梁东梅, 练婷玉, 尹明娟, 饶佳为, 倪进东. 高龄初产妇妊娠并发症和不良妊娠结局分析[J]. 上海交通大学学报(医学版), 2021, 41(11): 1485-1490.
[10]	祖娟，钱方媛，吴迪，谢新欣，任庆国，张志珺. 成年晚发型糖原贮积症Ⅱ型临床特征及基因突变分析[J]. 上海交通大学学报(医学版), 2020, 40(8): 1108-1112.
[11]	林静1, 2，刘含1, 2，刘欣梅1, 2，陈小君1，黄荷凤1, 2. 高龄初产妇与高龄经产妇的妊娠结局比较[J]. 上海交通大学学报（医学版）, 2020, 40(1): 58-.
[12]	吴轲 1，孙涵潇 2，蔡美琴 1. 类胡萝卜素对母婴健康影响的研究进展[J]. 上海交通大学学报（医学版）, 2019, 39(8): 929-.
[13]	张素群，倪琛，盛美萍，汪云. 体外受精－胚胎移植术中单胚胎移植与双胚胎移植的妊娠结局及影响因素分析[J]. 上海交通大学学报（医学版）, 2019, 39(6): 642-.
[14]	余小燕 1, 2，李霞 1. 载脂蛋白E基因型与常见重性精神疾病的关联性[J]. 上海交通大学学报（医学版）, 2018, 38(6): 704-.
[15]	王柳，丘彦. 多囊卵巢综合征患者结合珠蛋白基因型及血清水平的研究[J]. 上海交通大学学报（医学版）, 2017, 37(4): 532-.