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Does Gestational Diabetes Cause Additional Risk in Twin Pregnancy?
Annabel C M Sheehan1, Mark P Umstad1, Stephen Cole1
1Division of Maternity Services,The Royal Women's Hospital,Melbourne,Australia.
Summary
Twin pregnancies significantly increase risks for adverse perinatal outcomes, except macrosomia. Gestational diabetes mellitus (GDM) primarily elevates the risk of neonatal hypoglycemia in these pregnancies.
Area of Science:
- Perinatal Medicine
- Maternal-Fetal Medicine
- Endocrinology
Background:
- Concomitant gestational diabetes mellitus (GDM) may worsen adverse perinatal outcomes in twin pregnancies.
- Understanding the independent risks of twin pregnancy and GDM is crucial for perinatal care.
Purpose of the Study:
- To assess the separate risks of twin pregnancy and GDM on adverse perinatal outcomes.
- To compare the impact of twin gestation versus GDM on specific poor perinatal outcomes.
Main Methods:
- Retrospective cohort study of 13,527 women from 2016-2017.
- Inclusion of uncomplicated singleton pregnancies, pregnancies with GDM, twin pregnancies, and twin pregnancies with GDM.
- Univariate and multivariate analyses to evaluate perinatal outcomes: macrosomia, cesarean delivery, neonatal hypoglycemia, and preterm birth.
Main Results:
- Twin pregnancies were associated with higher risks of cesarean delivery (OR 8.40) and preterm birth (OR 58.82) compared to GDM.
- GDM was a stronger predictor of neonatal hypoglycemia (OR 4.87) than twin pregnancy.
- Twin pregnancy showed a higher risk for all adverse outcomes except macrosomia; GDM's impact was limited to hypoglycemia.
Conclusions:
- Twin pregnancy is a significant independent risk factor for most adverse perinatal outcomes, including cesarean delivery and preterm birth.
- Gestational diabetes mellitus poses a distinct risk, primarily increasing the likelihood of neonatal hypoglycemia.
- Clinical management should consider the specific risks posed by twin gestation and GDM separately.
Keywords:
cesarean deliverygestational diabetes mellitusmacrosomianeonatal hypoglycemiapreterm birthtwin pregnancyMore Related Videos
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