González González Nieves L, González Dávila Enrique, Goya Maria, Vega Begoña, Hernández Suarez Mercedes, Bartha Jose L
Departamento de Obstetricia y Ginecología, Hospital Universitario de Canarias, Tenerife, Spain.
Departamento de Estadística, I.O. y Computación, Universidad de La Laguna, Tenerife, Spain.
Int J Gynaecol Obstet. 2014 Jul;126(1):83-7. doi: 10.1016/j.ijgo.2014.01.022. Epub 2014 Apr 5.
To assess the impact of twin versus singleton pregnancy on obstetric and perinatal outcomes among women with pregestational diabetes mellitus (DM).
Multicenter retrospective cohort study of women with pregestational DM and twin or singleton pregnancy, conducted in Spain during 2005-2010. Each group included 63 women (type 1 DM, n=39; type 2 DM, n=24).
Of 269 565 deliveries, 68 (0.025%) were twins of mothers with pregestational DM, with 28/63 (44.4%) conceptions achieved with assisted reproduction technology. Among women with type 1 DM, hypertensive complications were more common among those with twins than among controls (13% versus 3%, P=0.02); the rate of preterm birth was higher (69% versus 15%, P<0.001); and the rate of admission to the neonatal intensive care unit was higher (51% versus 21%, P=0.005). Twin pregnancy was an independent risk factor for adverse perinatal outcomes regardless of the type of diabetes.
Twin pregnancy in women with either type of DM dramatically increased the risk of perinatal morbidity. In mothers with type 1 DM, twin pregnancy was more often associated with hypertensive complications than singleton pregnancy. Transfer of more than one embryo should be avoided if ART is needed in a woman with DM.
评估双胎妊娠与单胎妊娠对孕前糖尿病（DM）女性产科及围产期结局的影响。
对2005 - 2010年期间在西班牙进行的孕前DM且怀有双胎或单胎妊娠的女性进行多中心回顾性队列研究。每组包括63名女性（1型糖尿病，n = 39；2型糖尿病，n = 24）。
在269565例分娩中，68例（0.025%）为孕前DM母亲的双胎妊娠，其中28/63（44.4%）的妊娠是通过辅助生殖技术实现的。在1型糖尿病女性中，双胎妊娠者的高血压并发症比对照组更常见（13%对3%，P = 0.02）；早产率更高（69%对15%，P < 0.001）；新生儿重症监护病房收治率更高（51%对21%，P = 0.005）。无论糖尿病类型如何，双胎妊娠都是围产期不良结局的独立危险因素。
两种类型糖尿病女性的双胎妊娠均显著增加围产期发病风险。在1型糖尿病母亲中，双胎妊娠比单胎妊娠更常伴有高血压并发症。糖尿病女性如需进行辅助生殖技术，应避免移植多个胚胎。
