Abstract
Aim
To compare fetomaternal outcomes between GDM pregnant women with twin versus singleton pregnancies and then between women with GDM versus non-GDM twin pregnancies.
Methods
We performed a retrospective study including GDM pregnant women with both twin and singleton pregnancies followed in our tertiary center between 2011 and 2018. The fetomaternal characteristics of each group were compared. We then compared women with GDM twin pregnancy followed at our institution between 2011 and 2018 to non-GDM twin pregnant women giving childbirth in 2018.
Results
A total of 1127 GDM pregnant women were evaluated: 42 with twin pregnancy and 1085 with singleton pregnancy. Preeclampsia (14.3% vs. 3.3%, p < 0.001) and cesarean delivery (76.2% vs. 36.9%, p < 0.001) were more frequent among women with twin pregnancy. Neonatal morbidity was also more common among neonates delivered from twin pregnant women, including preterm labor (73.8% vs. 7.8%, p < 0.001), hypoglycemia (6% vs. 4.8%, p = 0.043), hyperbilirubinemia (33.3% vs. 9.0%, p < 0.001), RDS (28.6% vs. 2.7%, p < 0.001), admission in NICU (32.1% vs. 4.5%, p < 0.001) and SGA (19.0% vs. 11.0%, p = 0.001). Overall there were no significant differences in fetomaternal morbidity parameters between GDM (n = 42) versus non-GDM (n = 83) twin pregnancies, although SGA infants were more frequent in the latter group (33.9% vs. 19.0%, p = 0.014).
Conclusions
In GDM pregnant women, twin pregnancy seems to be associated with an increased prevalence of neonatal morbidity when compared to singleton pregnancy. On the other hand, in twin pregnancy, diagnosis of GDM does not seem to be associated with poorer fetomaternal outcomes. GDM seems to be protective for the occurrence of SGA neonates in twin pregnancies.
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Abbreviations
- ART:
-
Assisted reproductive technology
- BMI:
-
Body mass index
- FPG:
-
Fasting plasma glucose
- GDM:
-
Gestational diabetes mellitus
- IADPSG:
-
International association for diabetes in pregnancy study group
- IGT:
-
Impaired glucose tolerance
- IOM:
-
Institute of medicine
- IU:
-
International units
- LGA:
-
Large for gestational age
- NA:
-
Not applicable
- NICU:
-
Neonatal intensive care unit
- OGTT:
-
Oral glucose tolerance test
- PPDM:
-
Prepregnancy diabetes mellitus
- RDS:
-
Respiratory distress syndrome
- SGA:
-
Small for gestational age
- T2DM:
-
Type 2 diabetes mellitus
- TDD:
-
Total daily dose
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SSM, LF and JD designed the study. LF acquired the data; SSM, LF and JD interpreted the data. SSM and LF drafted the work and all authors revised it critically for important intellectual content. All authors approved the final version submitted and are accountable for all aspects of the work. All authors read and approved the final manuscript.
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This study was approved by the local Ethics committee (157-DEFI/156-CES).
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This article belongs to the topical collection Pregnancy and Diabetes, managed by Antonio Secchi and Marina Scavini.
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Monteiro, S.S., Fonseca, L., Santos, T.S. et al. Gestational diabetes in twin pregnancy: A predictor of adverse fetomaternal outcomes?. Acta Diabetol 59, 811–818 (2022). https://doi.org/10.1007/s00592-022-01874-3
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DOI: https://doi.org/10.1007/s00592-022-01874-3