Abstract
Background: Over the last decades, there has been a substantial increase in the incidence of higher-order multiple gestations. Twin pregnancies are associated with an increased risk of gestational diabetes mellitus (GDM). The literature on GDM rates in triplet pregnancies is scarce. Methods: A retrospective cohort study was performed to assess the prevalence of GDM in women with a triplet pregnancy. GDM was defined through an abnormal oral glucose tolerance test (OGTT). A meta-analysis of GDM prevalence was also carried out. Results: A cohort of 60 women was included in the analysis. Of these, 19 (31.7%) were diagnosed with GDM. There were no differences in pregnancy outcomes between women with and without GDM. In the meta-analysis of 12 studies, which used a sound GDM definition, an estimated pooled prevalence of 12.4% (95% confidence interval: 6.9–19.1%) was found. In a leave-one-out sensitivity analysis, the estimated GDM prevalence ranged from 10.7% to 14.1%. Conclusion: The rate of GDM seems increased in women with triplets compared to singleton pregnancies. However, GDM did not impact short-term pregnancy outcomes.
Highlights
Over the last decades, there has been a substantial increase in the incidence of higher-order multiple gestations because of assisted reproductive techniques [1]
The rate of gestational diabetes mellitus (GDM) seems increased in women with triplets compared to singleton pregnancies
None of the patients affected with GDM became insulin dependent
Summary
There has been a substantial increase in the incidence of higher-order multiple gestations because of assisted reproductive techniques [1]. The mother undergoes several physiologic adaptions in order to provide the best support for the growing fetus These include alterations in insulin sensitivity, i.e., an increase in early and a decrease in later pregnancy [5]. Assisted reproductive techniques (ART) are associated with an increase in maternal age compared to spontaneously conceived pregnancies, and increased maternal age is in turn independently associated with increased gestational diabetes mellitus (GDM) prevalence. Methods: A retrospective cohort study was performed to assess the prevalence of GDM in women with a triplet pregnancy. Conclusion: The rate of GDM seems increased in women with triplets compared to singleton pregnancies.
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