Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Korea.
Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, Seoul, Korea.
BMC Pregnancy Childbirth. 2022 Jan 3;22(1):9. doi: 10.1186/s12884-021-04361-9.
To compare obstetric and neonatal outcomes in twin pregnancies with or without gestational diabetes mellitus (GDM) before and after changes in GDM diagnostic criteria.
This was a retrospective cohort study of 1,764 twin pregnancies including 130 women with GDM (GDM group) and 1,634 women without GDM (non-GDM group). Patients with pregestational diabetes, unknown GDM status, and fetal death at < 24 gestational weeks were excluded. Obstetric and neonatal outcomes were compared between the two groups by two periods: period 1 (1995-2005) and period 2 (2005-2018) when National Diabetes Data Group criteria and Carpenter and Coustan criteria were used for diagnosis of GDM, respectively.
The incidence of GDM in twin pregnancies increased from 4.0% in period 1 to 9.3% in period 2. Composite obstetric complications rate was significantly higher in the GDM group than that in the non-GDM group during period 1 (72.0% vs. 45.5%, P = 0.009). However, it became comparable during period 2 (60.0% vs. 57.4%, P = 0.601). Interaction between GDM and period indicated a significant differential effect of GDM by period on the rate of composite obstetric complications. The rate of composite neonatal complications was similar between the two groups during both periods. The interaction between GDM and period was not significant.
After changes of GDM diagnostic criteria, the incidence of GDM increased more than twice, and the rate of composite obstetric complications decreased, but the rate of composite neonatal complications did not change significantly.
比较妊娠期糖尿病（GDM）诊断标准改变前后，有无 GDM 的双胎妊娠的产科和新生儿结局。
这是一项回顾性队列研究，纳入了 1764 例双胎妊娠，包括 130 例 GDM 患者（GDM 组）和 1634 例无 GDM 患者（非 GDM 组）。排除孕前糖尿病、GDM 状态未知和孕 24 周前胎儿死亡的患者。比较两组在两个时期的产科和新生儿结局：分别使用美国国家糖尿病数据组（National Diabetes Data Group）标准和 Carpenter 和 Coustan 标准诊断 GDM 的时期 1（1995-2005 年）和时期 2（2005-2018 年）。
双胎妊娠 GDM 的发生率从时期 1 的 4.0%增加到时期 2 的 9.3%。时期 1 时，GDM 组的复合产科并发症发生率明显高于非 GDM 组（72.0% vs. 45.5%，P=0.009）。然而，在时期 2 时，两组间无显著差异（60.0% vs. 57.4%，P=0.601）。GDM 和时期之间的交互作用表明，GDM 对复合产科并发症发生率的影响在时期间存在显著差异。两个时期两组间复合新生儿并发症发生率相似。GDM 和时期之间的交互作用不显著。
GDM 诊断标准改变后，GDM 的发生率增加了两倍多，复合产科并发症发生率降低，但复合新生儿并发症发生率无明显变化。
