![]() The increase in HbA1c in T3 is caused by an increase in the mean postprandial blood glucose values. The decrease in HbA1c levels in the first trimester (T1) is known to be caused by lower pre- and postprandial mean blood glucose values and an increase in young erythrocytes, which causes a decrease in the percentage of HbA1c. These assertions suggest that, in order to ensure optimal glycemic control in pregnant woman with diabetes, it is necessary to use HbA1c reference values specific for each trimester. In addition, it has been shown that red cell turnover increases in a normal pregnancy, which contributes to a decrease in HbA1c. Erythrocytes half-life decreases during pregnancy, which is reflected in a decrease in HbA1c. Some physiological changes in HbA1c during pregnancy should be considered to determine its optimal value for glycemic control. An HbA1c target value ranging between 6 and 6.5% (42–48 mmol/mol) is recommended however, an HbA1c of 6% (42 mmol/mol) may be optimal as a woman’s pregnancy progresses. Īccording to the American Diabetes Association (ADA), health care providers and patients can use two techniques to evaluate the efficacy of glycemic control treatment: blood glucose self-monitoring (BGS) and hemoglobin A1c (HbA1c). ![]() Good glycemic control is the first target of treatment for women with GDM. Several studies have shown that tight control of blood glucose levels during pregnancy may decrease the risk of adverse perinatal outcomes. The Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study reported associations between maternal glucose levels and increased birth weight, cesarean rate, and increased serum levels of C-peptide in the umbilical cord. ĭuring pregnancy, diabetes increases the risk of adverse perinatal outcomes, such as congenital malformations, macrosomia, preeclampsia, large fetus for gestational age, cesarean birth, and neonatal morbidity. The International Diabetes Federation estimated a global prevalence of 16.9% for hyperglycemia in pregnancy in 2013. Gestational diabetes mellitus (GDM) refers to diabetes diagnosed in the second trimester (T2) or third trimester (T3) of pregnancy that is not clearly overt diabetes. ![]() Pregestational diabetes refers to any type of diabetes diagnosed before a pregnancy. We suggest as upper limits of HbA1c value ≤5.6%, 5.5%, and 5.7% for T1, T2, and T3, respectively among Mexican pregnant women. The reference range of HbA1C in healthy Mexican pregnant women during pregnancy was 4.4% to 5.6%. ![]() The HbA1c reference intervals were calculated in terms of the 2.5th to the 97.5th percentiles. HbA1c was measured using high-performance liquid chromatography based on the National Glycohemoglobin Standardization Program-certified PDQ Primus guidelines. Women with gestational diabetes mellitus, pregestational diabetes, anemia, a pregestational BMI < 18.5 or ≥ 25 kg/m 2, and any hematologic, hepatic, immunological, renal, or cardiac disease were excluded. This cross-sectional study included healthy Mexican pregnant women in trimester 1 (T1), 6–13.6 weeks of gestation (WG), trimester 2 (T2), 14–27 WG, and trimester 3 (T3), ≥27–36 WG, with a maternal age > 18 years, and pregestational body mass index (BMI) ranging between 18.5–24.9 kg/m 2. The study aims to determine the reference intervals for HbA1c at each trimester in healthy Mexican pregnant women. The reference intervals for hemoglobin A1c (HbA1c) in pregnant Mexican women without diabetes are not well defined.
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