AlQarni Amani M, Alghamdi Amal A, Aljubran Hussain J, Bamalan Omar A, Abuzaid Abdullah H, AlYahya Mohammed A, AlAwami Ahmed M, Al Shubbar Mohammed D, Al Yousif Ghada F
Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Int J Womens Health. 2024 May 13;16:797-809. doi: 10.2147/IJWH.S462163. eCollection 2024.
Haemoglobin A1C (HbA1c) is fundamental in monitoring glycaemic control during pregnancy. However, several conditions could affect this test's accuracy, including iron deficiency anaemia (IDA). Hence, this systematic review delves into the underexplored connection between IDA, iron replacement therapy (IRT), and haemoglobin A1C (HbA1c) during pregnancy. An electronic search of the Cochrane, MEDLINE, and Embase databases was conducted by six authors. From a comprehensive search strategy, 968 records were obtained. After applying the inclusion and exclusion criteria, seven studies were included, comprising 365 women selected for analysis. Six studies indicated a positive correlation between IDA and HbA1c levels, while one found no correlation. The average HbA1c level of the included studies in pregnant women was 5.64%. In comparison, it was found that non-pregnant women had lower HbA1c levels. Among the included studies, the mean HbA1c levels decreased from 5.1% to 4.89% after treating pregnant women with IRT. The review emphasises the complexity of interpreting HbA1c levels in pregnant women with IDA, highlighting the influence of pregnancy-induced physiological changes. In addition, this suggests that HbA1c should not be the sole criterion for diabetes management in pregnant women with IDA. Future research should focus on alternative glycaemic monitoring methods unaffected by IDA.
糖化血红蛋白(HbA1c)在孕期血糖控制监测中至关重要。然而,包括缺铁性贫血(IDA)在内的多种情况可能会影响该检测的准确性。因此,本系统评价深入探讨了孕期IDA、铁剂替代疗法(IRT)与糖化血红蛋白(HbA1c)之间尚未充分探索的联系。六位作者对Cochrane、MEDLINE和Embase数据库进行了电子检索。通过全面的检索策略,共获得968条记录。在应用纳入和排除标准后,纳入了七项研究,包括365名入选进行分析的女性。六项研究表明IDA与HbA1c水平呈正相关,而一项研究未发现相关性。纳入研究中孕妇的平均HbA1c水平为5.64%。相比之下,发现非孕妇的HbA1c水平较低。在纳入的研究中,用IRT治疗孕妇后,平均HbA1c水平从5.1%降至4.89%。该评价强调了在患有IDA的孕妇中解释HbA1c水平的复杂性,突出了妊娠引起的生理变化的影响。此外,这表明HbA1c不应成为患有IDA的孕妇糖尿病管理的唯一标准。未来的研究应侧重于不受IDA影响的替代血糖监测方法。