Incidence and risk factors for gestational diabetes mellitus in twin versus singleton pregnancies
Incidence and risk factors for gestational diabetes mellitus in twin versus singleton pregnancies
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DOI：
10.1007/s00404-018-4847-9
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发表时间：
2018-09-01
影响因子：
2.6
通讯作者：
Melamed, Nir
中科院分区：
文献类型：
--
作者：
Hiersch, Liran;Berger, Howard;Melamed, Nir
比较双胎和单胎妊娠妇女妊娠期糖尿病（GDM）的发病率和危险因素。回顾性研究安大略（2012-2016）所有双胎或单胎分娩妇女。GDM的风险比（RR）和95% CI（按治疗类型分层）根据相关混杂变量进行调整。多变量Poisson回归分析用于确定双胎和单胎妊娠GDM的危险因素，在270，843名符合纳入标准的妇女中，266，942名（98.6%）为单胎妊娠，3901名（1.4%）为双胎妊娠。双胞胎妇女的总体GDM风险（aRR = 1.13，95%CI 1.01-1.28）和饮食治疗的GDM风险（aRR = 1.20，95%CI 1.01-1.42）显著更高，而与胰岛素治疗的GDM的相关性不显著（aRR = 1.07，95%CI 0.89-1.28）。母亲年龄> 35岁、非高加索人种和BMI > 30 kg/m2是双胞胎和单胞胎妇女GDM的独立危险因素，这些因素与GDM的关联程度相似。双胞胎妇女GDM的危险性增加，主要是由于饮食治疗的GDM发生率较高。尽管双胞胎妇女GDM的基线风险较高，但已知GDM风险因素的影响与单胞胎相似。
To compare the incidence and risk factors for gestational diabetes mellitus (GDM) between women with twin and singleton pregnancies.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.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/m(2) 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.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.