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Aspects to Consider in Adopting Pregnancy-Specific Reference Intervals.

Year: 2015
Type: article
Abstract: This commentary will focus on the changes in maternal physiology which result in changes in electrolyte and acid-base status during pregnancy. These are also the biochemical parameters being considered for the first round of harmonisation of pregnancy reference intervals by the AACB. The analytes addressed in this commentary will include sodium, potassium, chloride, bicarbonate, urea and creatinine. The currently-proposed reference intervals in pregnancy (as discussed at the 2015 AACB Harmonisation Meeting) are outlined. However it should be noted that these are currently not ratified and may be subject to change. All laboratories are encouraged to assess their own pregnancy data against these proposed intervals and provide feedback to the AACB Harmonisation Committee. Data from a large Australian data set of pregnant women has been provided (Figure 1) and may provide a helpful reference point for individual laboratories as they conduct their own internal data reviews. Figure (A to G). Changes in electrolyte parameters observed in 30,321 women of varying gestational age. The gridlines represent the non-pregnant reference limits for young women and the slanted percentages given at the 50th centiles represent the percentage of the pregnant ... Why are Pregnancy Reference Intervals Needed in Clinical Biochemistry? Reference intervals are designed to identify the range of results observed in healthy individuals. If healthy physiology changes, such as in pregnancy, a different interval may be required to identify health in this setting. Having appropriate reference intervals for pregnancy allows clinicians to avoid interpreting normal results as pathological and assists them in identifying results which are truly abnormal.1,2 Taking the further step of providing common reference intervals in pregnancy provides uniform information and may assist clinicians by reducing confusion and may optimise patient care.3 Not all biochemical parameters are altered by changing physiology in pregnancy but for those that are, it is necessary to consider whether the change is sufficiently significant to warrant a different reference interval.4 Whether a change is significant or not is ideally determined by clinical outcome,5 but if this is not possible, significance of a change may be determined by clinical opinion or statistical evidence.4
Language: English
Open Access status: green
OpenAlex ID: W2413180330
FWCI: 1.212
Cites: 30
Cited by: 8
Related to: 10