Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, PR China; Beijing Maternal and Child Health Care Hospital, PR China; Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, PR China.
Department of Obstetrics and Gynecology, Xicheng Women and Children's Health Hospital, PR China.
Clinics (Sao Paulo). 2023 Aug 19;78:100272. doi: 10.1016/j.clinsp.2023.100272. eCollection 2023.
This study aimed to investigate the mid-pregnancy blood glucose levels of women with singleton or twin pregnancies.
The relationship between blood glucose levels and Gestational Diabetes Mellitus (GDM) was studied in women with different pre-pregnancy Body Mass Index (BMI), and the effect of GDM on twin pregnancy outcomes was analyzed. Women with twin (n = 1,985) and singleton (n = 1,985) pregnancies were categorized into underweight (BMI < 18.5 kg/m, n = 597), normal weight (BMI: 18.5-23.9 kg/m, n = 2,575), and overweight/obese (BMI ≥ 24 kg/m, n = 798) groups.
The incidence of GDM was 21.01% in women with twin pregnancies. Among the women with GDM in twin pregnancies, 38.37% had at least two abnormal blood glucose levels. The incidence of these parameters increased with preconception BMI, and the incidence of twin pregnancies was higher than that of singleton pregnancies (p < 0.001). In the normal weight and overweight/obese group, the oral glucose tolerance test glucose level and incidence of GDM were higher in women with twin than singleton pregnancies (p < 0.05). For twin pregnancies, the prevalence of selective fetal growth restriction was higher and anemia was lower in the GDM group than in the non-GDM group (all p < 0.05).
Therefore, a greater emphasis should be placed on BMI before conception, and well-controlled GDM does not increase adverse pregnancy outcomes for twin pregnancies.
本研究旨在探讨单胎或双胎妊娠妇女的孕中期血糖水平。
研究了不同孕前体重指数（BMI）的妇女血糖水平与妊娠期糖尿病（GDM）的关系，并分析了 GDM 对双胎妊娠结局的影响。将双胎（n=1985）和单胎（n=1985）妊娠的妇女分为消瘦组（BMI<18.5kg/m2，n=597）、正常体重组（BMI：18.5-23.9kg/m2，n=2575）和超重/肥胖组（BMI≥24kg/m2，n=798）。
双胎妊娠妇女 GDM 的发病率为 21.01%。在双胎妊娠 GDM 妇女中，有 38.37%至少有两个异常血糖水平。这些参数的发生率随着孕前 BMI 的增加而增加，双胎妊娠的发生率高于单胎妊娠（p<0.001）。在正常体重和超重/肥胖组中，双胎妊娠妇女的口服葡萄糖耐量试验葡萄糖水平和 GDM 发病率高于单胎妊娠妇女（p<0.05）。对于双胎妊娠，GDM 组的选择性胎儿生长受限发生率较高，贫血发生率较低（均为 p<0.05）。
因此，应该更加重视孕前 BMI，并且良好控制的 GDM 不会增加双胎妊娠的不良妊娠结局。
