Burden, associated risk factors and adverse outcomes of gestational diabetes mellitus in twin pregnancies in Al Ain, UAE

Juma Alkaabi,Taoufik Zoubeidi,Charu Sharma,Raya Almazrouei,Abdul-Kader Souid,Nasloon Ali,Amel Eisa Almiri,Fatema M Alkaabi,Luai A Ahmed,Fatima Rashid Alkendi

doi:10.1186/s12884-020-03289-w

Juma Alkaabi, Taoufik Zoubeidi + Show 8 more

Open Access

https://doi.org/10.1186/s12884-020-03289-w

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Abstract

BackgroundGestational diabetes mellitus (GDM) in singleton pregnancies represent a high-risk scenario. The incidence, associated factors and outcomes of GDM in twin pregnancies is not known in the UAE.MethodsThis was five years retrospective analysis of hospital records of twin pregnancies in the city of Al Ain, Abu Dhabi, UAE. Relevant data with regards to the pregnancy, maternal and birth outcomes and incidence of GDM was extracted from two major hospitals in the city. Regression models assessed the relationship between socio-demographic and pregnancy-related variables and GDM, and the associations between GDM and maternal and fetal outcomes at birth.ResultsA total of 404 women and their neonates were part of this study. The study population had a mean age of 30.1 (SD: 5.3), overweight or obese (66.5%) and were majority multiparous (66.6%). High incidence of GDM in twin pregnancies (27.0%). While there were no statistical differences in outcomes of the neonates, GDM mothers were older (OR: 1.09, 95% CI: 1.06–1.4) and heavier (aOR: 1.02, 95% CI: 1.00 -1.04). They were also likely to have had GDM in their previous pregnancies (aOR: 7.37, 95% CI: 2.76–19.73). The prognosis of mothers with twin pregnancies and GDM lead to an independent and increased odds of cesarean section (aOR: 2.34, 95% CI: 1.03–5.30) and hospitalization during pregnancy (aOR: 1.60, 95% CI: 1.16–2.20).ConclusionMore than a quarter of women with twin pregnancies were diagnosed with GDM. GDM was associated with some adverse pregnancy outcomes but not fetal outcomes in this population. More studies are needed to further investigate these associations and the management of GDM in twin pregnancies.

Highlights

Gestational diabetes mellitus (GDM) in singleton pregnancies represent a high-risk scenario
Twin pregnancies are often associated with high risk of cesarean section, pre-eclampsia, hypoglycemia, retinopathy, preterm birth and low birth weight [15,16,17,18,19,20], GDM in twin pregnancies have shown conflicting associations to these adverse outcomes [21,22,23,24]
Age and weight at conception were significantly associated with the development of GDM in twin pregnancies, while GDM was significantly associated with hospitalization during twin pregnancy and the advent of a cesarean section in these pregnancies

Summary

Introduction

Gestational diabetes mellitus (GDM) in singleton pregnancies represent a high-risk scenario. The incidence, associated factors and outcomes of GDM in twin pregnancies is not known in the UAE. GDM is a major cause for concern during pregnancy It is associated with several adverse outcomes such as cesarean section, pre-eclampsia, macrosomia, shoulder dystocia, neonatal intensive care unit admission, and perinatal death [5,6,7,8,9]. Twin pregnancies are often associated with high risk of cesarean section, pre-eclampsia, hypoglycemia, retinopathy, preterm birth and low birth weight [15,16,17,18,19,20], GDM in twin pregnancies have shown conflicting associations to these adverse outcomes [21,22,23,24]

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