بررسی دلایل موثر بارداری مجدد مادران کودکان مبتلا به تالاسمی ماژور در مراجعین به درمانگاههای خون بیمارستانهای وابسته به وزارت بهداشت درمان و آموزش پزشکی سال 1371

  A causal – comparative study was carried on mothers of children with thalassemic major in Tehran. The purpose of the study was to identify factors affecting the family's decision for having a second child and disregarding the fact that this disorder may be carried to the new baby as well.   A total of 300 mothers having children with thalassemia major attending the haematology clinic supervised by the minisitry of health medical education in Tehran were selected randomly. The sampling continued for eight weeks until a hundred mothers with one thalassemic child who asserted, they have decided to stop child bearing, (control) and two hundred mothers with more than one thalassemic child (study group) were selected.   The hypothesis of the study were:   1- The knowledge of women with thalassemia major children about the disease is a decisive factor in planning to stop child bearing.   2- The availability of health support measure for the women with thaassemic children is a decisive factor in their planning for further pregnancies.   3- The beliefs of the women, with thalassemic children, about the disease, and it's outcome, is a decisive factor in their planning to stop child bearing.   The tool of this study was a 34 item questionnaire, seventeen items were assigned to persuasing the family characteristics related to the birth of thalassemic children born of carrier parents and seventeen items questioned the mothers knowledge and beliefs about the disease and the reasons she chose to continue with pregnancies after having given birth to one with thalassemic major. The questionnaire also investigated the health support measure available to the family.   The first and third hypothesis were supported the knowledge score of the control group was higher than those of the study group. statistical test showed a significant correlation between the mother's knowledge and her planning to prevent child bearing (R<99.9). All women in the control group believed that thalassemic families should limit their pregnancies in order to control the spread of this disorder in the community.   The second hypothesis was rejected since health support measures were equally available to both groups an interesting finding indicated that 96% of all the subjects stated: "If I knew that I am a carrier of the disease, and so is the man, and marrying him will result in giving birth to children with this major problem, I would not choose to marry him''. Thus the need for premarriage blood examination and counseling for a genetic evaluation of the couples is evident. It will serve as a positive measure for limiting the number of thalassemic children in the community, a disease that can only be controled by preventing the birth of such children.   Based on the fidings recommendations for continuity of care and public education were made.   Topics for further studies were also suggested.