TY - JOUR
T1 - Incidence and risk factors for gestational diabetes mellitus in twin versus singleton pregnancies
AU - for DOH-NET (Diabetes, Obesity and Hypertension in Pregnancy Research Network) and SOON (Southern Ontario Obstetrical Network) Investigators™
AU - Hiersch, Liran
AU - Berger, Howard
AU - Okby, Rania
AU - Ray, Joel G.
AU - Geary, Michael
AU - Mcdonald, Sarah D.
AU - Murry-Davis, Beth
AU - Riddell, Catherine
AU - Halperin, Ilana
AU - Hasan, Haroon
AU - Barrett, Jon
AU - Melamed, Nir
N1 - Funding Information:
Funding This study was funded by Canadian Institute of Health Research (CIHR) (Grant# 146442; Non-communicable Diseases in Obstetrics: Improving Quality of Care and Maternal-infant Outcomes Through an Obstetrical Research Network). Dr. Sarah D. McDonald is supported by a Tier II Canada Research Chair. Dr. Beth Murray-Davis is supported by a Hamilton Health Sciences Early Career Award. None of the funding agencies had any role in the idea, design, analyses, interpretation of data, writing of the manuscript or decision to submit the manuscript.
Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Objective: To compare the incidence and risk factors for gestational diabetes mellitus (GDM) between women with twin and singleton pregnancies. Methods: 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. Results: 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/m2 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. Conclusions: 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.
AB - Objective: To compare the incidence and risk factors for gestational diabetes mellitus (GDM) between women with twin and singleton pregnancies. Methods: 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. Results: 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/m2 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. Conclusions: 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.
KW - Diet
KW - Gestational diabetes mellitus
KW - Incidence
KW - Risk factors
KW - Twins
UR - http://www.scopus.com/inward/record.url?scp=85049575143&partnerID=8YFLogxK
U2 - 10.1007/s00404-018-4847-9
DO - 10.1007/s00404-018-4847-9
M3 - Article
AN - SCOPUS:85049575143
SN - 0932-0067
VL - 298
SP - 579
EP - 587
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 3
ER -
