Changes in hemoglobin F levels in pregnant women unaffected by clinical fetomaternal hemorrhage.
BACKGROUND
Complete automation of high-performance liquid chromatography (HPLC) for determination of hemoglobin F (%Hb F) and hemoglobin A1c (%Hb A1c) levels has made this procedure available in many clinical laboratories. However, the physiological changes in %Hb F during pregnancy and the effects of physiological and supraphysiological levels of %Hb A1c on measurement of %Hb F have not been studied extensively.


METHODS
Simultaneous determination of %Hb F and %Hb A1c was conducted in 490 blood samples obtained before (n=21), during the 1st (n=150), 2nd (n=116), and 3rd (n=192) trimesters of pregnancy, and postpartum (n=11) from 357 women, including 60 women with hyperglycemia but unaffected by clinical fetomaternal hemorrhage, by HPLC.


RESULTS
Mean (SD) Hb F levels were 0.71% (0.25%) before pregnancy. The value of 0.82% (0.47%) during the 1st trimester decreased significantly to 0.66% (0.35%) during the 2nd trimester and to 0.58% (0.38%) during the 3rd trimester. The level was 0.62% (0.31%) approximately one year after delivery. Thus, %Hb F was highest during the 1st trimester of pregnancy. The effects of varied %Hb A1c levels on %Hb F measurements were clinically negligible.


CONCLUSIONS
The data presented in this work may be used as reference intervals of %Hb F determined with HPLC during pregnancy.
Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. amataka@med.hokudai.ac.jp
Takashi
T
Yamada
Mamoru
M
Morikawa
Takahiro
T
Yamada
Ryutaro
R
Nishida
Masamitsu
M
Takeda
Satoshi
S
Kawaguchi
Hisanori
H
Minakami
D000328:Adult; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D005260:Female; D005319:Fetal Hemoglobin / Q000032:analysis*; D005331:Fetomaternal Transfusion / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D008137:Longitudinal Studies; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy; D011264:Pregnancy Trimesters / Q000097:blood*; D012016:Reference Values
D005319:Fetal Hemoglobin; D006442:Glycated Hemoglobin