Factors influencing neonatal hypoglycemia in dichorionic twins
10.3760/cma.j.cn113903-20240518-00358
- VernacularTitle:双绒毛膜双胎新生儿低血糖的影响因素
- Author:
Yilin HE
1
;
Huixia YANG
Author Information
1. 北京大学第一医院妇产生殖医学中心，北京 100034
- Keywords:
Twin pregnancy;
Neonatal hypoglycemia;
Risk factor
- From:
Chinese Journal of Perinatal Medicine
2024;27(10):816-821
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the factors influencing neonatal hypoglycemia in dichorionic twins.Methods:Clinical data of 304 dichorionic twin pregnancies and their neonates delivered at Peking University First Hospital from January 1, 2022, to December 31, 2023, were retrospectively collected. The cases were divided into a neonatal hypoglycemia group ( n=53) and a control group ( n=251) based on the occurrence of neonatal hypoglycemia. General conditions of the two groups were compared. Additionally, analysis was conducted based on the birth weight difference between the twins, with 18% as the threshold, dividing them into groups with birth weight differences≥18% (56 pregnant women and 112 newborns delivered) and<18% (248 pregnant women and 496 newborns delivered). Data comparisons between groups were performed using t-test, Mann-Whitney U test, Chi-square test, or Fisher's exact test. Paired t-test was used to compare the clinical features between the larger and smaller twins in different birth weight difference groups. Poisson regression analysis was applied to examine the association between maternal clinical characteristics and neonatal hypoglycemia. Results:In the groups with birth weight differences <18% and ≥18%, the incidence of neonatal hypoglycemia in smaller and larger twins were 13.7% (34/248) and 13.3% (33/248), 8.9% (5/56) and 7.1% (4/56), respectively. The umbilical cord blood glucose levels were 3.1 mmol/L (2.7-3.6 mmol/L) and 3.1 mmol/L (2.7-3.6 mmol/L), 3.3 mmol/L (2.8-4.3 mmol/L) and 3.4 mmol/L (3.0-4.3 mmol/L), respectively, with no statistically significant differences (all P>0.05). Poisson regression analysis showed that young gestational age at delivery, hyperglycemia in pregnancy, and fetal lung maturation promotion were risk factors for neonatal hypoglycemia [ RR values (95% CI) were 1.024 (1.002-1.049), 1.707 (1.051- 2.782), and 1.744 (1.011-3.027), respectively, all P<0.05]. Conclusions:Regardless of weight difference, there is no significant difference in umbilical cord blood glucose and the risk of postnatal hypoglycemia between larger and smaller twins. Preterm birth, hyperglycemia in pregnancy and corticosteroid-induced fetal lung maturation are associated with neonatal hypoglycemia in dichorionic twins.
