Abstract
We previously reported a logistic regression model for prediction of GDM from maternal characteristics and medical history in 75,161 singleton pregnancies. In this study of 1376 twin and 13,760 singleton pregnancies recruited at 11–13 weeks’ gestation, we extend the model to include terms for twin pregnancies. We found the respective odds of GDM in dichorionic and monochorionic twin pregnancies to be 1.36 (95% CI: 1.02–1.81) and 2.78 (95% CI: 1.72–4.48) times higher than in singleton pregnancies. In both singleton and twin pregnancies, the risk for GDM increased with maternal age and weight and birth weight z-score of a baby in a previous pregnancy and is higher in women with a previous pregnancy complicated by GDM; in those with a first- or second-degree relative with diabetes mellitus; in women of Black, East Asian, and South Asian racial origin; and in pregnancies conceived through the use of ovulation-induction drugs. In singleton pregnancies, at 10% and 20% false-positive rate, the detection rate was 43% and 58%, respectively. In twin pregnancies, using risk cut-offs corresponding to 10% and 20% false-positive rates in singletons, the respective false-positive rates were 27% and 47%, and the detection rates were 63% and 81%.
Highlights
Gestational diabetes mellitus (GDM) is associated with a plethora of complications for both mother and baby in short and long term [1,2,3,4,5,6]
In a previous study of 75,161 singleton pregnancies, we developed a screening model for GDM by combining various maternal characteristics and history through multivariate logistic analysis, and we compared the screening performance of our model with that recommended by National Institute of Health and Care Excellence (NICE) [8,9]
In the GDM groups in both singleton and twin pregnancies, the women tended to be older, heavier, and shorter, and there was a higher proportion of Black, South Asian, and East Asian racial origin; conceptions with in-vitro fertilization; history of first- or second-degree relative with diabetes; and previous pregnancies complicated by GDM or higher birth weight of last neonates
Summary
Gestational diabetes mellitus (GDM) is associated with a plethora of complications for both mother and baby in short and long term [1,2,3,4,5,6]. In a previous study of 75,161 singleton pregnancies, we developed a screening model for GDM by combining various maternal characteristics and history through multivariate logistic analysis, and we compared the screening performance of our model with that recommended by National Institute of Health and Care Excellence (NICE) [8,9]. Our study showed that the performance of screening for GDM was superior when using a multivariate logistic model rather than treating each maternal factor as an independent screening test [8,9]. Twin pregnancies, compared to singletons, are at increased risk of pregnancy complications, including miscarriage, stillbirth, preterm birth, fetal growth restriction, and preeclampsia [10,11,12]. There is contradictory evidence concerning the incidence of GDM in twin pregnancies, with some studies reporting that this is higher than in singletons [13,14,15,16,17,18], while others found that the rates are similar [17,18]
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