Clinical features and maternal–fetal outcome of pregnancy with aplastic anaemia: A single‐centre retrospective study

Pregnancy complicated by aplastic anaemia (AA) is rare but high risk, with historically poor maternal-fetal outcomes. Contemporary multidisciplinary management may improve prognosis, underscoring the need to clarify current outcomes and risk factors. We conducted a single-centre retrospective cohort study of 54 women with AA who had a total of 65 pregnancies, including those diagnosed with AA during pregnancy (n = 8) and those with a pre-existing AA diagnosis (n = 57). Most patients with new-onset AA presented with severe cytopenia at diagnosis. Although none responded to therapy during pregnancy, all six who continued their pregnancies had live births; two opted out due to severe cytopenia. In the pre-existing AA group, 88% of pregnancies resulted in live births, with a 47% rate of severe maternal or fetal complications. Pre-delivery haemoglobin and platelet counts were significantly lower in the complication group (73 g/L and 20 × 10⁹/L vs. 85 g/L and 29 × 10⁹/L, p < 0.05). Active disease (relapse or lack of remission) before delivery was strongly associated with adverse outcomes (78% vs. 37%, p = 0.002). No maternal deaths or neonatal haematological abnormalities were observed. Pregnancy with AA can achieve favourable outcomes with multidisciplinary management. Pre-delivery disease activity and haematological parameters (haemoglobin and platelet counts) are significant predictors of complications.