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YU Li Jin, WANG Hong Yu. Association between gestational diabetes mellitus and adverse perinatal outcome of dichorionic diamniotic sac twins[J]. CHINESE JOURNAL OF WOMEN AND CHILDREN HEALTH, 2023, 14(6): 62-66. DOI: 10.19757/j.cnki.issn1674-7763.2023.06.011
Citation: YU Li Jin, WANG Hong Yu. Association between gestational diabetes mellitus and adverse perinatal outcome of dichorionic diamniotic sac twins[J]. CHINESE JOURNAL OF WOMEN AND CHILDREN HEALTH, 2023, 14(6): 62-66. DOI: 10.19757/j.cnki.issn1674-7763.2023.06.011

Association between gestational diabetes mellitus and adverse perinatal outcome of dichorionic diamniotic sac twins

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  • Received Date: August 15, 2023
  • Available Online: December 14, 2023
  • Objective 

    To explore the influence of gestational diabetes mellitus (GDM) on perinatal adverse pregnancy outcomes of dichorionic diamniotic twins, so as to provide evidence for clinical standardized management and targeted treatment and reduce the occurrence of adverse perinatal pregnancy outcomes.

    Methods 

    Clinical data of 516 pregnant women with dichorionic diamniotic twin pregnancies from January 2018 to October 2022 who delivered babies at Shenzhen Baoan Women’s and Children’s Hospital of Guangdong were collected retrospectively. Among them, 258 pregnant women with diabetes were case group, and 258 pregnant women with normal glucose metabolism were control group. The pregnancy complications, the perinatal maternal and fetal outcomes were compared between 2 groups, and the impact of gestational blood glucose intervention on pregnancy outcomes of some women in case group were compared pre and post invention.

    Results 

    The incidence of severe preeclampsia, premature birth, and small for gestational age in the case group was much higher than that in the control group (all P < 0.05). The other aspects of maternal complications and perinatal maternal and fetal outcomes were not different between 2 groups (all P > 0.05). The incidence of anemia in case group was lower than that in control group (P < 0.05), but there was no statistically significant difference in the proportion of cases requiring blood transfusion for severe anemia between 2 groups (P > 0.05). Further intervention on twin pregnant women with diabetes was carried out. In the case group, 140 cases received blood glucose intervention, and 118 cases did not. Compared with those who did not receive intervention, the incidence of severe preeclampsia, premature rupture of membranes, intrauterine infections, and premature birth was lower among those who did it (all P < 0.05).

    Conclusion 

    GDM does not increase the risk of other pregnancy complications, perinatal maternal and infant except for severe preeclampsia, preterm birth, and small for gestational age in dichorionic diamniotic twins. Blood glucose intervention among twin pregnant women with diabetes can reduce the incidence of severe preeclampsia, premature rupture of membranes, intrauterine infection and premature delivery.

  • [1]
    薛聪颖,杨慧霞. 双胎妊娠合并妊娠期糖尿病的研究进展[J]. 中国妇产科临床杂志,2020,21(3):332-334.
    [2]
    中华医学会围产医学分会胎儿医学学组,中华医学会妇产科学分会产科学组,孙路明,等. 双胎妊娠临床处理指南(2020年更新)[J]. 中国产前诊断杂志:电子版,2021,13(1):51-63.
    [3]
    Su RN,Zhu WW,Wei YM,et al. Maternal and neonatal outcomes in multiple pregnancy:a multicentre study in the Beijing population[J]. Chronic Dis Transl Med,2015,1(4):197-202.
    [4]
    American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 190:Gestational Diabetes Mellitus[J]. Obstet Gynecol,2018,131(2):e49-e64. doi: 10.1097/AOG.0000000000002501
    [5]
    Hiersch L,Berger H,Okby R,et al. Gestational diabetes mellitus is associated with adverse outcomes in twin pregnancies[J]. Am J Obstet Gynecol,2019,220(1):102. e1-102. e8.
    [6]
    刘天骄,梅又文,樊欣,等. 妊娠期糖尿病对双胎妊娠孕妇的母儿结局及双生子12月龄生长状况影响的巢式病例对照研究[J]. 实用妇产科杂志,2021,37(5):358-363.
    [7]
    Dinham GK,Henry A,Lowe S,et al. Twin pregnancies complicated by gestational diabetes mellitus:a single centre cohort study[J]. Diabet Med,2016,33(12):1659-1667. doi: 10.1111/dme.13076
    [8]
    Chai TYL,Rajaratnam RM,Deng D,et al. The prevalence of gestational diabetes mellitus in women diagnosed with nonalcoholic fatty liver disease during pregnancy:a systematicre view and meta-analysis[J]. J Diabetes Complications,2021,35(9):107991. doi: 10.1016/j.jdiacomp.2021.107991
    [9]
    Aviram A,Beigei H,Abdulaziz KE,et al. Outcome associate with hypertensive disorders of pregnancy in twin compare with singleton gestations[J]. Obstet Gynecol,2021,138(3):449-458. doi: 10.1097/AOG.0000000000004506
    [10]
    谢幸,孔北华,段涛. 妇产科学[M]. 9版. 北京:人民卫生出版社,2018:107.
    [11]
    Simões T,Queirós A,Correia L,et al. Gestational diabetes mellitus complicating twin pregnancies[J]. J Perinat Med,2011,39(4):437-440.
    [12]
    McGrath RT,Hocking SL,Scott ES,et al. Outcomes of twin pregnancies complicated by gestational diabetes:a meta-analysis of observational studies[J]. J Perinatol,2017,37(4):360-368. doi: 10.1038/jp.2016.254
    [13]
    肖辉云,于佳,刘裕,等. 妊娠期糖尿病不增加双胎妊娠不良围产结局风险[J]. 中华围产医学杂志,2016,19(5):345-349.
    [14]
    American Diabetes Association. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes − 2020[J]. Diabetes Care,2020,43:S14-S31. doi: 10.2337/dc20-S002
    [15]
    卢江炜,汤雪娟,顾翼洋. 体外受精-胚胎移植术后双胎与自然受孕双胎临床结局分析[J]. 现代实用医学,2019,31(1):77-79. doi: 10.3969/j.issn.1671-0800.2019.01.034
    [16]
    黄诗华. 妊娠期糖尿病对体外受精-胚胎移植双胎妊娠结局的影响[J]. 临床医学工程,2018,25(11):1491-1492.
    [17]
    Lowe WL,Scholtens DM,Lowe LP,et al. Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity[J]. JAMA,2018,320(10):1005-1016. doi: 10.1001/jama.2018.11628
    [18]
    González NL,Goya M,Bellart J,et al. Obstetric and perinatal outcome in women with twin pregnancy and gestational diabetes[J]. J Matern Fetal Neonatal,2012,25(7):1084-1089. doi: 10.3109/14767058.2011.622009
    [19]
    Lai FY,Johnson JA,Dover D,et al. Outcomes of singleton and twin pregnancies complicated by pre-existing diabetes and gestational diabetes:a population-based study in Alberta,Canada,2005-11[J]. J Diabetes,2016,8(1):45-55. doi: 10.1111/1753-0407.12255
    [20]
    Okby R,Weintraub AY,Sergienko R,et al. Gestational diabetes mellitus in twin pregnancies is not associated with adverse perinatal outcomes[J]. Arch Gynecol Obstet,2014,290(4):649-654. doi: 10.1007/s00404-014-3272-y
    [21]
    Luo ZC,Zhao YJ,Ouyang F,et al. Diabetes and perinatal mortality in twin pregnancies[J]. PLOS One,2013,8(9):0075354. doi: 10.1371/journal.pone.0075354
    [22]
    Ye W,Luo C,Huang J,et al. Gestational diabetes mellitus and adverse pregnancy outcomes:systematic review and meta-analysis[J]. BMJ,2022,5(25):377.
    [23]
    Kusinski LC,Murphy HR,De Lucia Rolfe E,et al. Dietary intervention in pregnant women with gestational diabetes; protocol for the DiGest randomised controlled trial[J]. Nutrients,2020,12(4):1165. doi: 10.3390/nu12041165
    [24]
    Teede HJ,Bailey C,Moran LJ,et al. Association of antenatal diet and physical activity-based interventions with gestational weight gain and pregnancy outcomes:a systematic review and meta-analysis[J]. JAMA Intern Med,2022,182(2):106-114. doi: 10.1001/jamainternmed.2021.6373

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