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Risk for gestational diabetes and hypertension for women with twin pregnancy compared to singleton pregnancy

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Abstract

Objectives

This study was undertaken to determine the incidence of pregnancy induced hypertension (PIH) and gestational diabetes (GDM) in twin pregnancies (TP) in comparison with singleton pregnancies (SP), and to test whether TP with GDM have a higher risk than TP without GDM, as is known to be the case in SP.

Materials and methods

Eighty-nine patients with TP who sought prenatal care between 1 September 1994 and 30 October 1997, were asked to participate. One hundred and seventy-eight of the 1,416 patients were matched in a 1:2 ratio by age, body-mass-index, parity, gestational age at screening, and ethnicity with a singleton pregnancy from our database dating from the same period. The diagnosis "hypertension" or "preeclampsia" was made using clinical criteria including a repeated blood pressure above 140/90 mm Hg. Maternal and fetal outcome were compared between SP and TP, between TP with and without pathological screening, between TP with and without GDM.

Results

Patients with TP did not have a higher rate of GDM but of PIH (GDM 3.4% vs. 3.4%, p=0.63; PIH 2.8% vs. 9.0%, p=0.036). Expectant mothers of twins whose glucose screening test was pathological have a higher incidence of hypertension than those whose screening test was normal (17.9% vs. 4.9%, p=0.048). Twins of gestational diabetics have a higher rate of admission to the neonatal intensive care unit than twins of healthy pregnant patients (100% vs. 31%, p=0.028).

Conclusions

TP are associated with a higher risk of hypertension than SP but not for GDM. Patients expecting twins who show a carbohydrate intolerance are at a higher risk for hypertension and fetal diabetes-associated complications.

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References

  1. Campbell DM, MacGillivray I (1979) Glucose tolerance in twin pregnancy. Acta Genet Med Gemellol (Roma) 28:283–287

    Google Scholar 

  2. Collins MS, Bleyl JA (1990) Seventy-one quadruplet pregnancies. Management and outcome. Am J Obstet Gynecol 162:1384–1392

    Article  CAS  PubMed  Google Scholar 

  3. Coonrod DV, Hickok DE, Zhu K, Easterling TR, Daling JR (1995) Risk factors for preeclampsia in twin pregnancies: a population based cohort study. Obstet Gynecol 85:645–650

    Article  CAS  PubMed  Google Scholar 

  4. Dwyer PL, Oats JN, Walstab JE, Beischer NA (1982) Glucose tolerance in twin pregnancy. Aust NZ J Obstet Gynaecol 22:131–133

    Article  CAS  Google Scholar 

  5. Goldenberg M, Kitzmiller JL, Abrams B, Cowan RM, Laros RK (1996) Obstetrics complications with GDM. Effects of maternal weight. Diabetes 40 [Suppl 2]:79–82

  6. Henderson CE, Scarpelli S, LaRosa D, Divon MY (1995) Assessing the risk of gestational diabetes in twin gestation. J Natl Med Assoc 87:757–758

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Innes KE, Wimsatt JH, McDuffie R (2001) Relative glucose tolerance and subsequent development of hypertension in pregnancy. Obstet Gynecol 97:905–910

    CAS  PubMed  Google Scholar 

  8. Kjos SL, Buchanan TA (1999) Gestational diabetes mellitus. N Engl J Med 34:1749–1756

    Article  Google Scholar 

  9. Moodley SP, Jialal I, Moodley J, Naicker RS, Marivate M (1984) Carbohydrate metabolism in African women with twin pregnancy. Diabetes Care 7:72–74

    Article  CAS  PubMed  Google Scholar 

  10. Naicker RS, Jialal I, Subrayen KT, Moodley J, Van Middelkoop A (1983) Carbohydrate metabolism in twin pregnancy. S Afr Med J 1983:538–540

    Google Scholar 

  11. Naidoo L, Jailal I, Moodley J, Desai R (1985) Intravenous glucose tolerance tests in women with twin pregnancy. Obstet Gynecol 66:500–502

    CAS  PubMed  Google Scholar 

  12. Olofsson P (1990) Triplet and quadruplet pregnancies—a forthcoming challenge also for the 'general' obstetrician. Eur J Obstet Gynecol Reprod Biol 35:159–171

    Article  CAS  PubMed  Google Scholar 

  13. Roach VJ, Lau TK, Wilson D, Rogers MS (1998) The incidence of gestational diabetes in multiple pregnancy. Aust NZ J Obstet Gynaecol 38:56–57

    Article  CAS  Google Scholar 

  14. Schwartz DB, Daoud Y, Zazula P, Govert G, Bronsteen R, Wright D, Copes J (1998) Gestational diabetes mellitus: metabolic and blood glucose parameters in singleton versus twin pregnancies. Am J Obstet Gynecol 181:912–914

    Article  Google Scholar 

  15. Spellacy WN, Buhi WC, Birk SA (1978) Human placental lactogen levels in multiple pregnancies. Obstet Gynecol 52:210–212

    CAS  PubMed  Google Scholar 

  16. Spellacy WN, Buhl WC, Birk SA (1980) Carbohydrate metabolism in women with a twin pregnancy. Obstet Gynecol 55:688–691

    CAS  PubMed  Google Scholar 

  17. Wein P, Warick MM, Beischer NA (1992) Gestational diabetes in twin pregnancy: prevalence and long-term implications. Aust NZ J Obstet Gynaecol 32:325–327

    Article  CAS  Google Scholar 

  18. Zhang J, Bowes WA Jr, Grey TW, McMahon MJ (1996) Twin delivery and neonatal and infant mortality: a population-based study. Obstet Gynecol 88:593–598

    Article  CAS  PubMed  Google Scholar 

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Acknowledgement

K.J.B. is supported by a University Lecturing Qualification Grant from the Charité.

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Correspondence to Kai J. Buhling.

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A part of this study was presented at the 62nd Congress of the American Diabetes Association

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Buhling, K.J., Henrich, W., Starr, E. et al. Risk for gestational diabetes and hypertension for women with twin pregnancy compared to singleton pregnancy. Arch Gynecol Obstet 269, 33–36 (2003). https://doi.org/10.1007/s00404-003-0483-z

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  • DOI: https://doi.org/10.1007/s00404-003-0483-z

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