The relationship between glucose patterns in OGTT and adverse pregnancy outcomes in twin pregnancies

Abstract Background Traditional fixed thresholds for oral glucose tolerance test (OGTT) results may inadequately prevent adverse pregnancy outcomes in twin pregnancies. This study explores latent OGTT patterns and their association with adverse outcomes. Methods This study retrospectively analyzed 2...

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Main Authors: Wei‐Zhen Tang, Qin‐Yu Cai, Yi‐Fan Zhao, Hao‐wen Chen, Xia Lan, Xia Li, Li Wen, Ying‐Xiong Wang, Tai‐Hang Liu, Lan Wang
Format: Article
Language:English
Published: Wiley 2024-10-01
Series:Journal of Diabetes
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Online Access:https://doi.org/10.1111/1753-0407.70016
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author Wei‐Zhen Tang
Qin‐Yu Cai
Yi‐Fan Zhao
Hao‐wen Chen
Xia Lan
Xia Li
Li Wen
Ying‐Xiong Wang
Tai‐Hang Liu
Lan Wang
author_facet Wei‐Zhen Tang
Qin‐Yu Cai
Yi‐Fan Zhao
Hao‐wen Chen
Xia Lan
Xia Li
Li Wen
Ying‐Xiong Wang
Tai‐Hang Liu
Lan Wang
author_sort Wei‐Zhen Tang
collection DOAJ
description Abstract Background Traditional fixed thresholds for oral glucose tolerance test (OGTT) results may inadequately prevent adverse pregnancy outcomes in twin pregnancies. This study explores latent OGTT patterns and their association with adverse outcomes. Methods This study retrospectively analyzed 2644 twin pregnancies using latent mixture models to identify glucose level patterns (high, HG; medium, MG; and low, LG) and their relationship with maternal/neonatal characteristics, gestational age at delivery, and adverse outcomes. Results Three distinct glucose patterns, HG, MG, and LG patterns were identified. Among the participants, 16.3% were categorized in the HG pattern. After adjustment, compared with the LG pattern, the HG pattern was associated with a 1.79‐fold, 1.66‐fold, and 1.32‐fold increased risk of stillbirth, neonatal respiratory distress, and neonatal hyperbilirubinemia, respectively. The risk of neonatal ICU admission for MG and HG patterns increased by 1.22 times and 1.32 times, respectively, compared with the LG pattern. As gestational weeks increase, although there is an overlap in the confidence intervals between the HG pattern and other patterns in the restricted cubic splines analysis, the trend suggests that pregnant women with the HG pattern are more likely to face risks of their newborns requiring neonatal intensive care unit admission, and adverse comprehensive outcomes, compared with other patterns. In addition, with age and body mass index increasing in HG mode, gestation weeks at delivery tend to be later than in other modes. Conclusion Distinct OGTT glucose patterns in twin pregnancies correlate with different risks of adverse perinatal outcomes. The HG pattern warrants closer glucose monitoring and targeted intervention.
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spelling doaj-art-adfb97e1ad7e4de5a389186d852fa58c2025-08-20T01:57:45ZengWileyJournal of Diabetes1753-03931753-04072024-10-011610n/an/a10.1111/1753-0407.70016The relationship between glucose patterns in OGTT and adverse pregnancy outcomes in twin pregnanciesWei‐Zhen Tang0Qin‐Yu Cai1Yi‐Fan Zhao2Hao‐wen Chen3Xia Lan4Xia Li5Li Wen6Ying‐Xiong Wang7Tai‐Hang Liu8Lan Wang9Department of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Bioinformatics School of Basic Medical Sciences, Chongqing Medical University Chongqing ChinaDepartment of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Bioinformatics School of Basic Medical Sciences, Chongqing Medical University Chongqing ChinaDepartment of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Bioinformatics School of Basic Medical Sciences, Chongqing Medical University Chongqing ChinaDepartment of Bioinformatics School of Basic Medical Sciences, Chongqing Medical University Chongqing ChinaDepartment of Obstetrics and Gynecology Women and Children's Hospital of Chongqing Medical University Chongqing ChinaAbstract Background Traditional fixed thresholds for oral glucose tolerance test (OGTT) results may inadequately prevent adverse pregnancy outcomes in twin pregnancies. This study explores latent OGTT patterns and their association with adverse outcomes. Methods This study retrospectively analyzed 2644 twin pregnancies using latent mixture models to identify glucose level patterns (high, HG; medium, MG; and low, LG) and their relationship with maternal/neonatal characteristics, gestational age at delivery, and adverse outcomes. Results Three distinct glucose patterns, HG, MG, and LG patterns were identified. Among the participants, 16.3% were categorized in the HG pattern. After adjustment, compared with the LG pattern, the HG pattern was associated with a 1.79‐fold, 1.66‐fold, and 1.32‐fold increased risk of stillbirth, neonatal respiratory distress, and neonatal hyperbilirubinemia, respectively. The risk of neonatal ICU admission for MG and HG patterns increased by 1.22 times and 1.32 times, respectively, compared with the LG pattern. As gestational weeks increase, although there is an overlap in the confidence intervals between the HG pattern and other patterns in the restricted cubic splines analysis, the trend suggests that pregnant women with the HG pattern are more likely to face risks of their newborns requiring neonatal intensive care unit admission, and adverse comprehensive outcomes, compared with other patterns. In addition, with age and body mass index increasing in HG mode, gestation weeks at delivery tend to be later than in other modes. Conclusion Distinct OGTT glucose patterns in twin pregnancies correlate with different risks of adverse perinatal outcomes. The HG pattern warrants closer glucose monitoring and targeted intervention.https://doi.org/10.1111/1753-0407.70016GDMOGTTpregnancy outcomestwin pregnancy
spellingShingle Wei‐Zhen Tang
Qin‐Yu Cai
Yi‐Fan Zhao
Hao‐wen Chen
Xia Lan
Xia Li
Li Wen
Ying‐Xiong Wang
Tai‐Hang Liu
Lan Wang
The relationship between glucose patterns in OGTT and adverse pregnancy outcomes in twin pregnancies
Journal of Diabetes
GDM
OGTT
pregnancy outcomes
twin pregnancy
title The relationship between glucose patterns in OGTT and adverse pregnancy outcomes in twin pregnancies
title_full The relationship between glucose patterns in OGTT and adverse pregnancy outcomes in twin pregnancies
title_fullStr The relationship between glucose patterns in OGTT and adverse pregnancy outcomes in twin pregnancies
title_full_unstemmed The relationship between glucose patterns in OGTT and adverse pregnancy outcomes in twin pregnancies
title_short The relationship between glucose patterns in OGTT and adverse pregnancy outcomes in twin pregnancies
title_sort relationship between glucose patterns in ogtt and adverse pregnancy outcomes in twin pregnancies
topic GDM
OGTT
pregnancy outcomes
twin pregnancy
url https://doi.org/10.1111/1753-0407.70016
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