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| Analysis the insulin resistance, blood glucose and lipid metabolism changes, and perinatal outcomes of pregnant women with twin and gestational diabetes mellitus |
| Jingzhou Central Hospital, Jingzhou, Hubei Province, 434401 |
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Abstract To investigate the changes of the insulin resistance, and blood glucose and lipid metabolism of pregnant women with gemellary pregnancy and gestational diabetes mellitus (GDM), and to study the correlation between them and the perinatal outcomes of the women. Methods: A retrospective analysis was performed. 47 pregnant women with twin and GDM from August 2016 to August 2019 were selected in study group, and 82 normal pregnant normal women with gemellary pregnancy during the same period were selected in control group. The levels of HOMA-IR, FINs，HOMA-β，blood glucose (fasting, 1 h after OGTT, 2 h after OGTT), prenatal HbA1c, and lipid metabolism (TC, TG, LDL-C, FFA) of the women in the two groups were measured. The maternal pregnancy outcomes were recorded and compared between the two groups. Results: The blood glucose levels of fasting, 1h and 2h after 75g OGTT of the women in the study group were all significant higher than those of the women in the control group (P<0.05), and there was no significant difference in prenatal HbA1c level of the women between the two groups (P>0.05). HOMA-IR value, and the levels of TC, TG, LDL-C, and FFA of the women in the study group were significant higher than those of the women in the control group, but the levels of FINS and HOMA-β of the women in the study group were significant lower (all P<0.05). The proportion of premature rupture of membranes (27.7%), high neonatal bilirubin concentration (9.6%), and macrosomia proportion (10.6%) of the women in the study group were significant higher than those of the women in the control group (P<0.05), but there were no significant differences in the rates of anemia, postpartum hemorrhage, hydramnios, gestational hypertension, and abruptions of membranes of the women, and the rates of neonatal hypoglycemia, premature birth, unidentity oftwins, and perinatal death between the two groups (P>0.05). Conclusion: The pregnant women with twin and GDM can increase the incidences of their premature rupture of membranes, neonatal hyperbilirubinemia, and macrosomia, which may be related to the aggravation of their insulin resistance and abnormal glucolipid metabolism because of GDM.
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