\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[greek,english]{babel}



\usepackage{float}








\begin{document}

\title{Pregnancy outcomes in women affected by fetal alpha-thalassemia: a case
control study}



\author[1]{Jiangheng Li}%
\author[2]{Jingli Yan}%
\author[2]{Yongquan Huang}%
\author[2]{Jinlu Wei}%
\author[2]{Bingyan Xie}%
\author[1]{Wu Jiang}%
\author[1]{Maoling Zhu}%
\affil[1]{Affiliated Nanning Maternal and Child Health Hospital of Guangxi Medical University}%
\affil[2]{Affiliation not available}%


\vspace{-1em}



  
  \date{June 17, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Objective: To evaluate the associations between fetal \selectlanguage{greek}α-\selectlanguage{english}thalassemia and
risk of adverse pregnancy outcomes. Design: Case control study. Setting:
Forty-two hospitals in Nanning, China. Participants: Pregnant women
\textgreater{}20 weeks of gestation. Methods: Multivariate logistic
regression analyses were performed to explore associations between fetal
\selectlanguage{greek}α-\selectlanguage{english}thalassemia and adverse pregnancy outcomes. Receiver operating
characteristic curve analyses were used to assess the use of selected
factors in predicting low Apgar scores. Main Outcome and Measure:
Pregnancy outcomes of thalassemic women whose fetuses had
non-thalassemia, \selectlanguage{greek}α-\selectlanguage{english}thalassemia trait or HbH disease. Results: With
thalassemic women whose fetuses were normal as the reference, fetuses in
the HbH disease group showed a higher increase in the odds of Apgar
scores being \textless{}7 at 1 minute (4.74\% vs 1.57\%) and 5 minutes
(2.84\% vs 0.67\%). With non-thalassemic women as the reference, this
trend was more obvious; whereas the normal fetal group was more likely
to be diagnosed with postpartum hemorrhage. Combining fetal HbH disease
and gestational age reflected medium accuracy in Apgar predictions.
Conclusions: Fetal HbH disease was associated with a higher risk of low
Apgar scores. Thalassemic women with normal fetuses may also have an
increased risk of postpartum hemorrhage, and should be monitored
accordingly. Funding: The Key Research and Development Programs of
Nanning, China (No. 20183038 and No. 20193097). Keywords: Fetal
alpha-thalassemia; Low Apgar scores; Postpartum hemorrhage. Tweetable
abstract: This study shows that fetal HbH disease may increase the risk
of low Apgar scores, and that thalassemic women with normal fetuses are
prone to postpartum hemorrhage.%
\end{abstract}%



\sloppy


\textbf{Hosted file}

\verb`manuscript.doc`  available at \url{https://authorea.com/users/470509/articles/562611-pregnancy-outcomes-in-women-affected-by-fetal-alpha-thalassemia-a-case-control-study}

\selectlanguage{english}
\FloatBarrier
\end{document}

