Obstetrics and gynecology · 2002
Impact of fetal reduction on the incidence of gestational diabetes.
Сравнительное исследованиеСтатьяПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Sivan Eyal, Maman Eti, Homko Carol J, Lipitz Shlomo, Cohen Shlomi, Schiff Eyal
Аннотация
OBJECTIVE: To estimate the rate of gestational diabetes in triplet pregnancies and to assess the impact of fetal reduction on the incidence of this complication.
METHODS: One hundred eighty-eight consecutive triplet pregnancies referred to the Sheba Medical Center between 1994 and 1998 were included. One hundred three of these pregnancies continued as triplets, whereas 85 women elected to undergo fetal reduction to twins. The incidence of gestational diabetes (based on the criteria of Carpenter and Coustan) and other outcome variables were compared between the two groups. Student t-tests and chi(2) analysis were used as appropriate.
RESULTS: Mean (+/-SD) maternal age was 29.2 +/- 4.8 in the triplet group and 29.3 +/- 4.1 in the reduction group. The groups had similar median parity (1.6 +/- 1.1 in the triplet group and 1.5 +/- 0.7 in the reduction group). The rate of gestational diabetes was significantly higher in the triplet group than in the reduction group (22.3% vs 5.8%). A lower birth weight (1764 +/- 448 g vs 2208 +/- 526 g) and an earlier gestational age at delivery (33.4 +/- 2.8 weeks vs 36.0 +/- 2.8 weeks) were observed in the triplet group compared with the reduction group.
CONCLUSION: The number of fetuses in multifetal pregnancies influences the incidence of gestational diabetes. These findings support the hypothesis that an increase in placental mass and, thus, an increase in diabetogenic hormones play a role in the etiology of gestational diabetes.
METHODS: One hundred eighty-eight consecutive triplet pregnancies referred to the Sheba Medical Center between 1994 and 1998 were included. One hundred three of these pregnancies continued as triplets, whereas 85 women elected to undergo fetal reduction to twins. The incidence of gestational diabetes (based on the criteria of Carpenter and Coustan) and other outcome variables were compared between the two groups. Student t-tests and chi(2) analysis were used as appropriate.
RESULTS: Mean (+/-SD) maternal age was 29.2 +/- 4.8 in the triplet group and 29.3 +/- 4.1 in the reduction group. The groups had similar median parity (1.6 +/- 1.1 in the triplet group and 1.5 +/- 0.7 in the reduction group). The rate of gestational diabetes was significantly higher in the triplet group than in the reduction group (22.3% vs 5.8%). A lower birth weight (1764 +/- 448 g vs 2208 +/- 526 g) and an earlier gestational age at delivery (33.4 +/- 2.8 weeks vs 36.0 +/- 2.8 weeks) were observed in the triplet group compared with the reduction group.
CONCLUSION: The number of fetuses in multifetal pregnancies influences the incidence of gestational diabetes. These findings support the hypothesis that an increase in placental mass and, thus, an increase in diabetogenic hormones play a role in the etiology of gestational diabetes.