This study investigated the long-term health outcomes of adults who suffered fetal anaemia and were treated with in utero transfusion.

The ANAEMIA Study compared adults who suffered fetal anaemia due to Rhesus disease and were treated with in utero transfusion at National Women’s Hospital, Auckland, between 1963 and 1990 with an unaffected cohort of siblings.

The researchers measured cardiac function, myocardial blood flow, heart rate variability, cardiovascular risk factors, renal and liver function in 88 sibling groups. The sibling comparison minimised the impact of genetic and lifestyle factors known to influence heart disease risk.

Overall, there was no difference in the incidence of heart disease between affected and unaffected siblings. However the affected adults were aged between 18 and 47 years at the time of the study, younger than the age at which heart disease usually appears.
Notably, survivors of fetal anaemia had smaller hearts and thicker-walled main heart chambers. They also had lower levels of HDL cholesterol and there were signs the inner lining of their blood vessels was working differently.

No differences were detected in other heart disease risk factors including body size, blood pressure, glucose tolerance, smoking, alcohol use, and exercise participation.
Because the affected adults all had both fetal anaemia and transfusions, it’s impossible to say from this study which one led to changes to their hearts.

A follow-up study on the same participants when they’re older is planned.

Key publications

Wallace AH, Dalziel SR, Cowan BR, A Young AA, Thornburg KL, Harding JE. Long-term cardiovascular outcome following fetal anaemia and intrauterine transfusion: a cohort study. Archives of Disease in Childhood.