ArticleThe Lancet regional health. Southeast Asia2026
Pregnancy induced hypertension and mirror syndrome associated with fetal hemoglobin Bart's disease in Thailand: a retrospective cohort study.
Article in The Lancet regional health. Southeast Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Planting seeds of cure before birth in α-thalassemia major.Blood advances · 2026Article
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9 authors.
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Abstract
Background: Pregnancy-induced hypertension (PIH) and mirror syndrome associated with fetal hemoglobin (Hb) Bart's disease have not been well characterized. This study primarily compared the incidence of these conditions in late gestation between affected and low-risk pregnancies, and secondarily assessed differences in other maternal complications. Methods: A large retrospective cohort study (between 1992 and 2022) was conducted at a single tertiary center. The consecutive singleton pregnancies with fetal Hb Bart's disease diagnosed at ≥24 weeks, considered as delayed diagnosis were recruited into the study group. The control group including low-risk pregnancies with a normal fetus were randomly selected at a 20:1 ratio. Medical records were comprehensively reviewed and validated for the inclusion criteria and pregnancy outcomes. Chi-square test with relative risks as well as Cox proportional hazard ratio were used to compare the main outcomes. Findings: A total of 142 pregnancies affected by fetal Hb Bart's disease and 2840 controls were included. The incidence of PIH in the study group was 83.8% (89 pregnancies) with a relative risk of 11.33 (95% CI: 9.77-13.15). The subgroup analysis showed markedly higher rates of gestational hypertension, preeclampsia in the study group. The incidence of mirror syndrome was markedly elevated; 70 (49.3%) vs. 2 (0.1%) with a relative risk of 700 (95% CI: 173-2826). The onset of PIH was significantly earlier in the study group. The rare but serious complications were significantly higher in the study group, including a high maternal mortality rate of 2.8%. Interpretation: Nearly all continuing pregnancies with Hb Bart's disease eventually developed earlier onset and more severe PIH and half developed mirror syndrome with a relative risk of 700 times. Severe morbidity and mortality were also much higher in the affected pregnancies. Funding: The Chiang Mai University Research Fund CMU-2567.
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