Trimester-specific reference ranges for glycated haemoglobin in pregnancy

Hdl Handle:
http://hdl.handle.net/10147/238854
Title:
Trimester-specific reference ranges for glycated haemoglobin in pregnancy
Authors:
O'Connor, C; O'Shea, P; Owens, L; Carmody, L; Avalos, G; Lydon, K; Nestor, L; Dunne, F
Affiliation:
Department of Endocrinology, Galway University Hospitals, Galway 2Department of Clinical Biochemistry, Galway University Hospitals, Galway
Publisher:
Diabetic Pregnancy Study Group
Issue Date:
2011
URI:
http://hdl.handle.net/10147/238854
Abstract:
Background and Aims: Diabetes in Pregnancy imposes additional risks to both mother and infant. These poor outcomes are considered to be primarily related to glycaemic control which is monitored longitudinally through pregnancy by means of HbA1c. The correlation between HbA1c levels with clinical outcomes emphasises the need to measure HbA1c accurately, precisely and for data interpretation comparison to appropriately defined reference intervals. From July 1st 2010, the HbA1c assay in Irish laboratories became fully metrologically traceable to the IFCC standard, permitting HbA1c to be reported in IFCC units (mmol/mol) and derived DCCT/NGSP units (%) using the IFCC-DCCT/NGSP master equation (DCCT = Diabetes Control and Complications Trial, NGSP = National Glycohemoglobin standardisation program). The aim of this project is to establish trimester-specific reference ranges in pregnancy for IFCC standardised HbA1c in non-diabetic Caucasian women. This will allow us to define the goal for HbA1c during pregnancy complicated by diabetes. Materials and methods: Following informed consent blood was collected from 234 pregnant and 36 age -matched controls into EDTA and Fluoride oxalate tubes for HbA1c, haemoglobin and glucose measurement. Pregnancy trimester was defined as follows: T1 (up to 12 weeks), T2 (13 to 27 weeks), T3 (>28 weeks to term). The Menarini HA8160 automated haemoglobin (Hb) analyser was used to assay HbA1c. Results: Non-parametric analysis of the data was performed. The 95% IFCC HbA1c (DCCT) reference interval for Controls (n=59) 29-37mmol/mol (4.8-5.5%), Trimester 1 (n=26) 36mmol/mol (4.6-5.4%), Trimester 2 (n=107) 25-35mmol.mol (4.4-5.4%) and Trimester 3 (n=107) 28- 39 mmol/mol (4.7-5.7%). A statistically significant difference between the median HbA1c concentration of the control and Trimester 2 subjects, p <0.0001 was determined (Mann-Whitney test). Conclusion: Trimester-specific HbA1c reference intervals are required to manage diabetes in pregnancy as HbA1c changes throughout pregnancy.
Item Type:
Conference Poster
Language:
en
Keywords:
DIABETES; PREGNANCY

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Connor, Cen_GB
dc.contributor.authorO'Shea, Pen_GB
dc.contributor.authorOwens, Len_GB
dc.contributor.authorCarmody, Len_GB
dc.contributor.authorAvalos, Gen_GB
dc.contributor.authorLydon, Ken_GB
dc.contributor.authorNestor, Len_GB
dc.contributor.authorDunne, Fen_GB
dc.date.accessioned2012-08-15T15:27:20Z-
dc.date.available2012-08-15T15:27:20Z-
dc.date.issued2011-
dc.identifier.urihttp://hdl.handle.net/10147/238854-
dc.description.abstractBackground and Aims: Diabetes in Pregnancy imposes additional risks to both mother and infant. These poor outcomes are considered to be primarily related to glycaemic control which is monitored longitudinally through pregnancy by means of HbA1c. The correlation between HbA1c levels with clinical outcomes emphasises the need to measure HbA1c accurately, precisely and for data interpretation comparison to appropriately defined reference intervals. From July 1st 2010, the HbA1c assay in Irish laboratories became fully metrologically traceable to the IFCC standard, permitting HbA1c to be reported in IFCC units (mmol/mol) and derived DCCT/NGSP units (%) using the IFCC-DCCT/NGSP master equation (DCCT = Diabetes Control and Complications Trial, NGSP = National Glycohemoglobin standardisation program). The aim of this project is to establish trimester-specific reference ranges in pregnancy for IFCC standardised HbA1c in non-diabetic Caucasian women. This will allow us to define the goal for HbA1c during pregnancy complicated by diabetes. Materials and methods: Following informed consent blood was collected from 234 pregnant and 36 age -matched controls into EDTA and Fluoride oxalate tubes for HbA1c, haemoglobin and glucose measurement. Pregnancy trimester was defined as follows: T1 (up to 12 weeks), T2 (13 to 27 weeks), T3 (>28 weeks to term). The Menarini HA8160 automated haemoglobin (Hb) analyser was used to assay HbA1c. Results: Non-parametric analysis of the data was performed. The 95% IFCC HbA1c (DCCT) reference interval for Controls (n=59) 29-37mmol/mol (4.8-5.5%), Trimester 1 (n=26) 36mmol/mol (4.6-5.4%), Trimester 2 (n=107) 25-35mmol.mol (4.4-5.4%) and Trimester 3 (n=107) 28- 39 mmol/mol (4.7-5.7%). A statistically significant difference between the median HbA1c concentration of the control and Trimester 2 subjects, p <0.0001 was determined (Mann-Whitney test). Conclusion: Trimester-specific HbA1c reference intervals are required to manage diabetes in pregnancy as HbA1c changes throughout pregnancy.en_GB
dc.language.isoenen
dc.publisherDiabetic Pregnancy Study Groupen_GB
dc.subjectDIABETESen_GB
dc.subjectPREGNANCYen_GB
dc.titleTrimester-specific reference ranges for glycated haemoglobin in pregnancyen_GB
dc.typeConference Posteren
dc.contributor.departmentDepartment of Endocrinology, Galway University Hospitals, Galway 2Department of Clinical Biochemistry, Galway University Hospitals, Galwayen_GB
dc.description.provinceConnachten
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