Risk Factors Analysis and Prediction of Twin Pregnancies Complicated with Gestational Diabetes Mellitus in Early Pregnancy
- VernacularTitle:双胎妊娠早期糖尿病相关危险因素分析及预测
- Author:
Jin-hui CUI
1
;
Ping LI
1
;
Li-ping OUYANG
1
;
Xin-juan CHEN
1
;
Ling LI
1
;
Jian-hui FAN
1
Author Information
1. Department of Obstetrics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
- Publication Type:Journal Article
- Keywords:
gestational diabetes mellitus;
twin pregnancy;
fasting plasma glucose;
triglycerides;
early prediction
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2020;41(6):944-950
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To explore the risk factors of twin pregnancies complicated with gestational diabetes mellitus (GDM) in early pregnancy, and search for effective predictors of GDM in twin pregnancy. 【Methods】 Retrospective analysis was performed on 318 patients of twin pregnancies who had regular prenatal examinations and delivered in The Third Affiliated Hospital of Sun Yat-sen University between January, 2015 and June, 2019. According to the results of 75 g oral glucose tolerance test(OGTT), 84 cases were assigned to the GDM group, and 234 cases were assigned to non-GDM group. The clinical characteristics of the subjects were recorded, including age, pre-pregnancy body mass index, gravidity, parity, medical history, mode of conception and chorionicity. The subjects' results of fasting plasma glucose, total cholesterol, triglycerides, high density lipoprotein, low density lipoprotein, and pregnancy-associated plasma protein-A, free beta subunit of human chorionic gonadotropin for Down's screening in early pregnancy(11~13+6 weeks) were also included. Risk factors were analyzed by multivariate-Logistic stepwise regression, and receiver-operating characteristic curve was used to evaluate the prediction of GDM in twin pregnancy. 【Results】 ① The age and pre-pregnancy body mass index of GDM group were higher than those of non-GDM group(P < 0.001), and the proportion of GDM group combined with polycystic ovary syndrome was higher(P < 0.05); ② FPG and TG in GDM group were higher than those of non-GDM group(P < 0.05), however, there was no difference in TC, HDL, LDL, PAPP-A MOM and Free β-HCG MOM between the two groups(P > 0.05); ③ Age, pre-pregnancy body mass index, PCOS history and FPG in early pregnancy were independent risk factors of GDM in twin pregnancy; ④ The AUC of FPG for predicting GDM in twin pregnancy was 0.617 (95%CI: 0.547 ~ 0.688), when FPG was 4.495 mmol/L, the Youden's index was 0.223 with sensitivity and specificity of 65.5% and 56.8%, respectively; The AUC of TG was 0.65(95%CI: 0.584 ~ 0.716), when TG was 1.195 mmol/L, the Youden's index was 0.24 with sensitivity and specificity of 77.4% and 46.6%, respectively; The AUC of FPG, TG combined age, pre-pregnancy body mass index, PCOS history was 0.751(95%CI: 0.693 ~ 0.810), with sensitivity and specificity of 73.8% and 70.1%, respectively. 【Conclusion】 Age, pre-pregnancy body mass index, PCOS history and FPG in early pregnancy were independent risk factors of GDM in twin pregnancy; FPG and TG in early pregnancy can be used to predict GDM in twin pregnancy, and when combined with clinical characteristics, can increase the value of prediction.
