OBJECTIVES

To investigate the influence of gestational diabetes mellitus on perinatal outcomes in women with twin pregnancies.

METHODS

A retrospective cohort study was performed with a total of 168 twin pregnancy delivered in the First Affiliated Hospital of Jinan University between January 2011 and December 2019. The twin women were assigned to two groups, including 94 cases complicated with gestational diabetes mellitus and 66 cases with normal glucose tolerance. Besides, we also matched the twin with single pregnant women in the corresponding period, and compared the perinatal outcomes.

RESULTS

The incidence rate of GDM among the twin pregnant women was 58.75%. Overall, in terms of the twin pregnancy, there are no differences in baseline characteristics between the NGT and GDM women (P>0.05 for all) except that the BMI (28.17 vs 27.28, p=0.07) and weight (72.01kg vs 69.51kg, p=0.09) of GDM twin mothers are higher than those without GDM. The babies of the NGT group are more likely to be small-gestational-age-infant (21.9% vs 2.1% p<0.01). Babies delivered by NGT mothers showed a higher rate of admission to NICU (84.4% vs 44.7% p<0.01). Generally, the maternal outcomes of the twin pregnant mother are worse than the single pregnant women (Table 4). Specifically, the twin mothers have a higher risk of getting gestational hypertension (10.7% vs 0.0% p=0.01 NGT) and preeclampsia (16.2% vs 2.6% p<0.01 in GDM women, 26.7% vs 3.6% p<0.01 in NGT women). There is a higher incidence of patent ductus arteriosus, patent foramen oval, hypokalemia, premature and hypoproteinemia in twins.

CONCLUSIONS

The twin pregnancy was associated with a higher rate of GDM, and the presence of GDM may decrease the rate of small-for-age infants, and the occurrence of NICU admission. Nevertheless, there is higher risk of pregnancy-related complications including gestational hypertension and preeclampsia.