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| Maternal and neonatal clinical characteristics of twin pregnant women with gestational diabetes mellitus and its influence on the neonatal early adverse outcomes |
| 1.The Third People’s Hospital of Chengdu / The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan Province, 610031; 2. School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region |
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Abstract To explore the maternal and neonatal clinical characteristics of twin pregnant women with gestational diabetes mellitus (GDM), and to study its influence on the neonatal early adverse outcomes. Methods: The maternal and neonatal clinical data of 719 twin pregnant women with GDM (in study group) from January 2017 to January 2022 were collected. The pregnant women with normal twin pregnancies during the same period were included in control group. The influence factors of the maternal and neonatal early adverse outcomes of the women with GDM were investigated by multivariate logistic regression analysis. Results: Among the pregnant women with GDM, the frequency of insulin used of the women with twin pregnancies was significantly lower than that of the women with singleton pregnancy (P<0.05), and the glycosylated hemoglobin level and the incidence of preeclampsia of the women with twin pregnancies during the third trimester of pregnancy were significantly higher than those of the women with singleton pregnancy (P<0.05). The neonatal diseases rate of the women with twin pregnancies was significantly higher than that of the women with singleton pregnancy, and the gestational weeks at delivery of the women with twin pregnancies was significantly less than that of the women with singleton pregnancy (P<0.05). The rates of the neonatal early adverse outcomes, such as small for gestational age (SGA), preterm birth, hyperbilirubinemia, and pneumothorax, of the women with twin pregnancies were significantly higher than those of the women with singleton pregnancy (P<0.05). The body mass index (BMI) value and the weight gain during pregnancy of the women in the study group were significantly lower than those of the women in the control group, and the cesarean section rate of the women in the study group was significantly higher (P<0.05). There was no significant difference in the early adverse outcomes of the women between the two groups (P>0.05). The incidences of neonatal SGA and large for gestational age (LGA) in the study group were significantly lower than those in the control group (P<0.05), and there was no significant difference in the early neonatal adverse outcomes (P>0.05). Multivariate logistic regression analysis showed that the SGA (OR=7.357, 95%CI 2.136-25.341), the preterm birth (OR=5.329, 95%CI 1.430-19.852), and the assisted reproductive technology used (OR=6.838, 95%CI 1.715-27.263) were the early risk factors of the neonatal adverse outcomes of the women with twins and GDM. Conclusion: The early active prevention and treatment of SGA and preterm birth, and the regular pre-pregnancy examination and better assisted reproductive technology of the pregnant women with twin pregnancies and GDM can effectively reduce the incidence of their neonatal early adverse outcomes.
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