Guillén M A, Herranz L, Barquiel B, Hillman N, Burgos M A, Pallardo L F
Division of Diabetes, Department of Endocrinology and Nutrition, Madrid, Spain.
Diabet Med. 2014 Dec;31(12):1651-6. doi: 10.1111/dme.12523. Epub 2014 Jul 9.
To evaluate the influence of gestational diabetes mellitus on neonatal birthweight, macrosomia and weight discrepancy in twin neonates.
An observational retrospective study was performed. One hundred and six women with gestational diabetes and twin pregnancy and 166 twin controls who delivered viable fetuses > 24 weeks were included. Impact of maternal pre-pregnancy BMI, smoking habit, method of conception, chorionicity, gestational age at delivery, mode of delivery and hypertensive complications were also analysed. The effect of maternal hyperglycaemia and metabolic control in gestational diabetes pregnancies was assessed.
Gestational hypertension and pre-eclampsia were significantly higher in the group with gestational diabetes (21.5% vs. 6.3%, P = 0.007 and 6.2% vs. 0%, P = 0.025). There were no differences in the incidence of macrosomia (5.7% vs. 7.2%, P = 0.803), large for gestational age (10.3% vs. 13.2%, P = 0.570), small for gestational age (10.3% vs. 12.0%, P = 0.701), severely small for gestational age (6.6% vs. 7.8%, P = 0.814) or weight discrepancy (20.6% vs. 15.2%, P = 0.320) in the group with gestational diabetes compared with twin pregnancies without diabetes. There were no differences when comparing insulin-requiring gestational diabetes pregnancies and twins without diabetes for any of the neonatal weight outcomes. There was no relationship between third trimester HbA1c and neonatal birthweight or infant birthweight ratio.
Gestational diabetes did not increase the risk of macrosomia or weight discrepancy of twin newborns. Furthermore, glycaemic control did not influence the rate of any of the weight outcomes in our study population. In twin pregnancies, gestational diabetes was associated with a higher risk of gestational hypertension and pre-eclampsia.
评估妊娠期糖尿病对双胎新生儿出生体重、巨大儿及体重差异的影响。
进行一项观察性回顾性研究。纳入106例患有妊娠期糖尿病的双胎妊娠妇女及166例分娩孕周>24周活胎的双胎对照。分析孕妇孕前体重指数、吸烟习惯、受孕方式、绒毛膜性、分娩孕周、分娩方式及高血压并发症的影响。评估妊娠期糖尿病孕妇母体高血糖及代谢控制的效果。
妊娠期糖尿病组妊娠期高血压和子痫前期的发生率显著更高（21.5% 对 6.3%，P = 0.007；6.2% 对 0%，P = 0.025）。与非糖尿病双胎妊娠相比，妊娠期糖尿病组巨大儿发生率（5.7% 对 7.2%，P = 0.803）、大于胎龄儿发生率（10.3% 对 13.2%，P = 0.570）、小于胎龄儿发生率（10.3% 对 12.0%，P = 0.701）、严重小于胎龄儿发生率（6.6% 对 7.8%，P = 0.814）或体重差异发生率（20.6% 对 15.2%，P = 0.320）均无差异。对于任何新生儿体重结局，比较需要胰岛素治疗的妊娠期糖尿病孕妇与非糖尿病双胎时均无差异。孕晚期糖化血红蛋白与新生儿出生体重或婴儿出生体重比之间无关联。
妊娠期糖尿病并未增加双胎新生儿巨大儿或体重差异的风险。此外，血糖控制并未影响我们研究人群中任何体重结局的发生率。在双胎妊娠中，妊娠期糖尿病与妊娠期高血压和子痫前期的较高风险相关。
