Incidence and risk factors for gestational diabetes mellitus in twin versus singleton pregnancies

Liran Hiersch¹, Howard Berger², Rania Okby³, Joel G Ray^{4

5

6}, Michael Geary², Sarah D Mcdonald^{7

8

9}, Beth Murry-Davis^{7

8

9}, Catherine Riddell¹⁰, Ilana Halperin¹¹, Haroon Hasan¹⁰, Jon Barrett³, Nir Melamed³; for DOH-NET (Diabetes, Obesity and Hypertension in Pregnancy Research Network) and SOON (Southern Ontario Obstetrical Network) Investigators™

Affiliations

¹ Department of Obstetrics and Gynecology, Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. lirhir@gmail.com.
² Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
³ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
⁴ Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
⁵ Department of Obstetrics, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
⁶ Department of Gynaecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
⁷ Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
⁸ Department of Radiology, McMaster University, Hamilton, ON, Canada.
⁹ Department of Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
¹⁰ Better Outcomes Registry and Network (BORN) Ontario, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada.
¹¹ Department of Endocrinology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

PMID: 29971559
DOI: 10.1007/s00404-018-4847-9

Incidence and risk factors for gestational diabetes mellitus in twin versus singleton pregnancies

Liran Hiersch et al. Arch Gynecol Obstet. 2018 Sep.

. 2018 Sep;298(3):579-587.

doi: 10.1007/s00404-018-4847-9. Epub 2018 Jul 3.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. lirhir@gmail.com.
² Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
³ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
⁴ Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
⁵ Department of Obstetrics, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
⁶ Department of Gynaecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
⁷ Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
⁸ Department of Radiology, McMaster University, Hamilton, ON, Canada.
⁹ Department of Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
¹⁰ Better Outcomes Registry and Network (BORN) Ontario, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada.
¹¹ Department of Endocrinology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

PMID: 29971559
DOI: 10.1007/s00404-018-4847-9

Abstract

Objective: To compare the incidence and risk factors for gestational diabetes mellitus (GDM) between women with twin and singleton pregnancies.

Methods: Retrospective study of all women who had a twin or singleton birth in Ontario (2012-2016). Risk ratios (RR) and 95% CIs for GDM (stratified by type of treatment) were adjusted for relevant confounding variables. Multivariable Poisson regression analysis was used to identify risk factors for GDM in twin and singleton gestations.

Results: Of 270,843 women who met inclusion criteria, 266,942 (98.6%) and 3901 (1.4%) had a singleton and a twin pregnancy, respectively. Women with twins had a significantly higher risk for overall GDM (aRR = 1.13, 95% CI 1.01-1.28) and diet-treated GDM (aRR = 1.20, 95% CI 1.01-1.42) while the association with insulin-treated GDM was not significant (aRR = 1.07, 95% CI 0.89-1.28). Maternal age ≥ 35 years, non-Caucasian ethnicity and BMI > 30 kg/m² were independent risk factors for GDM among women with twins and singletons, and the magnitude of the association of these factors with GDM was similar.

Conclusions: Women with twins are at increased risk of GDM, mainly due to a higher rate of diet-treated GDM. Despite higher baseline risk of GDM in women with twins, the effect of known risk factors for GDM is similar to that observed in singletons.

Keywords: Diet; Gestational diabetes mellitus; Incidence; Risk factors; Twins.

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Incidence and risk factors for gestational diabetes mellitus in twin versus singleton pregnancies

Affiliations

Incidence and risk factors for gestational diabetes mellitus in twin versus singleton pregnancies

Authors

Affiliations

Abstract

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous