Rosta Klara, Al-Bibawy Katharina, Al-Bibawy Maria, Temsch Wilhelm, Springer Stephanie, Somogyi Aniko, Ott Johannes
Department of Obstetrics and Gynecology, Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Center for Medical Statistic and Informatic and Intelligent Systems, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2020 Jul 15;9(7):2249. doi: 10.3390/jcm9072249.
In this study, we aimed to investigate the incidence of gestational diabetes mellitus (GDM) in women who carried twin pregnancies and received vaginal progesterone.
In this retrospective cohort study, 203 out of 1686 women with twin pregnancies received natural progesterone (200 mg/day between gestational weeks 16 + 0 and 36 + 0) vaginally for ≥ 4 weeks. The control group consisted of 1483 women with twin pregnancies without progesterone administration. Pearson's Chi squared test, Fisher's exact test, and Student's t-test was used to compare differences between the control and the progesterone-treated groups. A multivariate binary logistic regression was performed to assess relative independent associations on the dependent outcome of GDM incidence.
Vaginal progesterone treatment in twin pregnancies had no significant influence on developing GDM ( = 0.662). Higher pre-pregnancy BMI (OR 1.1; < 0.001), GDM in previous pregnancy (OR 6.0; < 0.001), and smoking during pregnancy (OR 1.6; = 0.014) posed an increased risk for developing GDM.
In twin pregnancies, the use of vaginal progesterone for the prevention of recurrent preterm delivery was not associated with an increased risk of GDM.
在本研究中，我们旨在调查怀有双胎且接受阴道用黄体酮治疗的女性中妊娠期糖尿病（GDM）的发生率。
在这项回顾性队列研究中，1686例怀有双胎的女性中有203例在妊娠16 + 0至36 + 0周期间每天经阴道接受200mg天然黄体酮治疗≥4周。对照组由1483例未接受黄体酮治疗的怀有双胎的女性组成。采用Pearson卡方检验、Fisher精确检验和Student t检验比较对照组和黄体酮治疗组之间的差异。进行多因素二元逻辑回归分析以评估GDM发生率这一相关结局的相对独立关联。
双胎妊娠阴道用黄体酮治疗对GDM的发生无显著影响（P = 0.662）。孕前BMI较高（OR 1.1；P < 0.001）、既往妊娠有GDM（OR 6.0；P < 0.001）以及孕期吸烟（OR 1.6；P = 0.014）会增加发生GDM的风险。
在双胎妊娠中，使用阴道用黄体酮预防复发性早产与GDM风险增加无关。
