The Incidence of Thalassemia in Premarital Testing in Mosul City: A Retrospective Cross-Sectional Study

Background: Thalassemia is an inherited haemoglobin disorder that represents an important public health concern in Iraq. Premarital screening facilitates the identification of carriers, genetic counselling, and assessment of reproductive risks among prospective couples. Objectives: To assess the frequency of recorded thalassemia-related findings among individuals attending premarital screening centres in Mosul City, with consideration of laboratory parameters, ABO blood groups, Rhesus factor, and parental consanguinity. Methods: A retrospective cross-sectional study was designed to evaluate premarital screening records from Ibn Sina Teaching Hospital, Ibn Al-Atheer Teaching Hospital, and Mosul General Hospital over the period from 2 January 2021 to 31 May 2026. The variables of interest included sex, haemoglobin concentration, haemoglobin A₂ (HbA₂), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), ABO blood group, Rhesus factor, parental consanguinity, and alpha- and beta-thalassemia status. Results: The available screening records for 2021–2025 included 213,510 individuals, among whom 6,352 were recorded as affected, representing 2.98% of the screened population. Males constituted 54.91% of affected cases, while females accounted for 45.09%. Beta-thalassemia represented 66.33%, alpha-thalassemia 10.20%, and other or undetermined findings 23.47%. The study demonstrated lower mean haemoglobin concentration among females than males (11.86 ± 1.34 versus 13.24 ± 1.47 g/dL). Mean HbA₂ was 4.73 ± 0.79% in females and 4.68 ± 0.83% in males, while mean MCV and MCH were slightly lower among females. Moreover, the study found that blood group O was the most frequent (43.51%), followed by A (24.78%), B (23.50%), and AB (8.21%). Rh-positive status accounted for 90.13% of the proposed distribution, while parental consanguinity was estimated at 25.77%. Conclusions: Premarital screening represents an important public health strategy for identifying individuals with thalassemia-related abnormalities and reducing the risk of severe inherited haemoglobin disorders in Mosul City. Strengthening standardized screening protocols, confirmatory laboratory testing, genetic counselling, and accurate electronic recordkeeping is recommended to improve early carrier identification and facilitate the detection of at-risk couples.