Appraisal of A1c% level in healthy Sudanese pregnant women in reference to body mass index

Abdelgadir Ali Elmugadam; Marwan Ismail; Abdelgadir Eltom

doi:10.18203/2320-1770.ijrcog20191928

Authors

Abdelgadir Ali Elmugadam Medical Laboratories Sciences, Sudan University of Sciences and Technology, Sudan
Marwan Ismail Medical Laboratories Sciences, College of Health Sciences, Gulf Medical University, Ajman, UAE
Abdelgadir Eltom Medical Laboratories Sciences, College of Health Sciences, Gulf Medical University, Ajman, UAE

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20191928

Keywords:

A1c%, Body mass index, Pregnancy

Abstract

Background: Pregnancy is a major endocrine event in the female lifespan, involving wide-ranged and often dramatic changes in the metabolism of various hormones. Cross sectional, case control, analytical quantitative study was conducted in Sudan, Khartoum state in Yastabsheron obstetric hospital during the period from March to August 2011. Analytical and statistical methods were applied to measure the concentration of A1c% in healthy pregnant women as well as in healthy non-pregnant women to assess the difference in the results.

Methods: Blood samples were taken from a total of 90 healthy pregnant women (case group) and 30 healthy non-pregnant women (control group), then samples were analyzed for A1c% by using affinity chromatography technique, and results were recorded in addition to their age, body mass index and the number of pregnancies.

Results: showed that, the mean concentration of the A1c% in cases group was (4.407±1.054%) in first trimester, (4.797±0.631) % in second trimester and (4.833±0.626) % in third trimester, and (5.670±0.471%) in control group with a P value of 0.00, indicating the highly significant difference between the two groups. Others finding showed that the mean concentration of A1c% of the first trimester is lower than that of the second and third trimesters, also there was no significant difference between the mean concentration of the second and third trimester. A significant weak positive correlation between A1c% concentration with body mass index and the age of pregnant women.

Conclusions: Healthy normal pregnant women have lower A1c% concentrations than non-pregnant women which can be impute to the reduce in plasma glucose values and to the shortened erythrocyte life span that can occur during pregnancy. The body mass index and age affect the concentration of A1c% c, but it is not affected by gravida.

Metrics

Metrics Loading ...

References

Marshall SM, Barth JH. Standardization of HbA1c measurements: a consensus statement. Diabet Med. 2000;17(1):5-6.

HuyA. Biochemical test in pregnancy. Australian Prescriber. 2005;28:96-101.

Evers IM, de Valk HW, Mol BW, ter Braak EW, Visser GH: Macrosomia despite good glycaemic control in type I diabetic pregnancy: results of a nationwide study in the Netherlands. Diabetologia. 2002;45(11):1484-9.

Lauenborg J, Mathiesen ER, Ovesen P, Westergaard JG, Ekbom P, Molsted-Pedersen L, et al. Audit on stillbirths in women with pregestational type 1 diabetes. Diabetes Care. 2003;26:1385-9.

Ekbom P, Damm P, Nogaard K, Clausen P, Feldt-Rasmussen U, Feldt-Rasmussen B, et al. Urinary albumin excretion and 24-hour blood pressure as predictors of pre-eclampsia in type I diabetes. Diabetol. 2000;43(7):927-31.

Kyne-Grzebalski D, Wood L, Marshall SM, Taylor R. Episodic hyperglycaemia in pregnant women with well-controlled type 1 diabetes mellitus: a major potential factor underlying macrosomia. Diabet Med. 1999;16(8):702-6.

Hartland AJ, Smith JM, Clark PMS, Webber J, Chowdhury T, Dunne F. Establishing trimester- and ethnic group-related reference ranges for fructosamine and HbA1c in non-diabetic pregnant women. Ann Clin Biochem. 1999;36(Pt 2):235-7.

O’Kane MJ, Lynch PLM, Moles KW, Magee SE. Determination of a diabetes control and complications trial-aligned HbA1c reference range in pregnancy. Clin Chim Acta. 2001;311(2):157-9.

Kilpatrick ES. Glycated haemoglobin in the year 2000. J Clin Pathol. 2000;53:335-9.

Kendrick JM. Preconception care of women with diabetes. J Perinat Neonatal Nurs. 2004;18(1):14-25.

Worth R, Potter JM, Drury J, Fraser RB, Cullen DR: Glycosylated haemoglobin in normal pregnancy: a longitudinal study with two independent methods. Diabetol. 1985;28(2):76-9.

Parentoni LS, de Faria EC, Bartelega MJ, Moda VM, Facin AC, Castilho LN. Glycated hemoglobin reference limits obtained by high performance liquid chromatography in adults and pregnant women. Clin Chim Acta. 1998;274(1):105-9.

Lind T, Cheyne GA. Effect of normal pregnancy upon the glycosylated haemoglobins. Br J Obstet Gynaecol. 1979;86(3):210-3.

Evers IM, de Valk HW, Visser GH. Riskof complications of pregnancy in womenwith type 1 diabetes: nationwide prospectivestudy in the Netherlands. BMJ 2004;328:915-918.

Richardson T, Kerr D. Obesity in type 2 diabetes - local experience in a district general hospital. Br J Diabetes Vasc Dis. 2003;3:49-52.

Greene MF. Spontaneous abortions and major malformations in women with diabetes mellitus. Semin Reprod Endocrinol. 1999;17:127-36.

Suhonen L, Hiilesmaa V, Teramo K. Glycaemic control during early pregnancy and fetal malformations in women with type I diabetes mellitus. Diabetol. 2000;43:79-82.

Abdelgadir AA, Ahmed LO, Ma BA. Correlation of oxidative stress markers malondialdehyde (MDA), antioxidant vitamins A, E, and C with glycated hemoglobin (HBA1C) levels in Type 2 diabetes mellitus. Asian J Pharm Clin Res. 2018;5:281-3.

Mosca A, Paleari R, Maria G. Dalfrà. Reference Intervals for Hemoglobin A1c in pregnant women: Data from an Italian multicenter study. Am Assoc Clin Chem. 2006;52:1138-43.

Jacques C, North ML, Pinget M, Moeglin D, Mayer S, Gandar R. Dorner Hemoglobin A1c and its variations in pregnancy. La Presse Medicale.1983;12(11):673-6.

Nilsen JR, Ekbom P, Damm P. HbA1c level are significantly lower in early and late pregnancy. Am Diabet Assoc. 2004;27:1200-1.