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  • Title: [Effect of pregnancy on hemoglobin A1 in normal and diabetic women (author's transl)].
    Author: Murata K, Miyamura Y, Toyoda N, Ikeda Y, Kozuka Y, Sugiyama Y.
    Journal: Nihon Sanka Fujinka Gakkai Zasshi; 1981 Oct; 33(10):1669-74. PubMed ID: 7310196.
    Abstract:
    Hemoglobin A1, a normal minor variant of adult HbA in which the N-terminal valine of the beta chain is glycosylated by a Schiff base. The increased levels of HbA1 in diabetic subjects have been correlated with various indicators of diabetic control during preceding weeks, suggesting that HbA1 measurement is an index of long term blood-glucose control. Considerable attention is now paid to diabetic control during pregnancy because maternal hyperglycemia is believed to be partly responsible for increased prevalence of fetal morbidity and mortality. HbA1 was assayed during pregnancy with the Helena glycosylated hemoglobin quik column kit using an ion exchange resin. 1. HbA1 correlated with HbA1c during pregnancy, r = 0.834, p less than 0.001. 2. HbA1 did not alter during pregnancy as compared to the non-pregnant group, 7.26 +/- 0.85% vs 7.09 +/- 0.60%. 3. There was no relationship between HbA1 and hemoglobin. 4. A significant direct relationship was not found for HbA1 and the infant weight. 5. The diabetic group had elevated levels of HbA1 to the normal group but gradually decreased to normal levels after a rigid control was achieved. 6. None of pregnant diabetics whose HbA1 was normal on presentation gave large baby for gestational age. It is speculated that these fluctuation in HbA1 are most likely due to changes in long-term blood glucose control. HbA should decline to reach a constant, low level as soon as possible in diabetic pregnancy. This tool should add in management of diabetic pregnancy to improve the outcome of pregnancy.
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