The Incidence of β‐Thalassaemia in Greek and Italian Migrants in Australia and its Effects in Pregnancy

Abstract

C onsiderable interest and attention has been manifested during the last decade in the distribution and incidence of the various types of abnormal haemoglobins and a large body of evidence relating to the haemoglobins S, C, D and E has been accumulated. The difficulty in establishing a definite diagnosis of the thalassaemia trait has, however, largely excluded this condition from the statistical studies. In our investigation into the incidence of thalassaemia in the Greek and Italian population of South Australia we have used two approaches to the problem. Firstly, we estimated the haemoglobin A 2 levels in the pregnant population at a maternity hospital on the assumption from previous work of our own and other workers (Josephson, Masri, Singer, Dworkin and Singer, 1958) that raised haemoglobin A 2 levels are found only in thalassaemia of the β type, in some patients with megaloblastic anaemia and in congenital spherocytic anaemia. These two latter conditions are relatively easy to differentiate on routine haematological grounds. Secondly, the bloods of all pregnant women with haemoglobin values of less than 11.O g. per 100 ml. were surveyed in an attempt to find any cases of thalassaemia with normal haemoglobin A 2 values on the grounds of microcytic anaemias with normal serumiron levels and showing no response to iron therapy. Apart from selected case reports there are few factual data available in the literature on the overall effects of pregnancy on the haematological status of the patient with thalassaemia. This aspect has been investigated in conjunction with the studies of the incidence of the β type of thalassaemia trait.