2bedc95a2932024b88f80af9ff355a14 pmc_33946383.pdf e6b49f31d67dbad2c291d143c4a7ac380b2a3bd0 pmc_33946383.pdf 90060c35556ad796c28fc6603ee2a8a2543a67bdf5296e56667daf28a0ae759e pmc_33946383.pdf Title: Trends in Prevalence of Diabetes among Twin Pregnancies and Perinatal Outcomes in Catalonia between 2006 and 2015: The DIAGESTCAT Study Subject: The aims of our study were to evaluate the trends in the prevalence of diabetes among twin pregnancies in Catalonia, Spain between 2006 and 2015, to assess the influence of diabetes on perinatal outcomes of twin gestations and to ascertain the interaction between twin pregnancies and glycaemic status. A population-based study was conducted using the Spanish Minimum Basic Data Set. Cases of gestational diabetes mellitus (GDM) and pre-existing diabetes were identified using ICD-9-CM codes. Data from 743,762 singleton and 15,956 twin deliveries between 2006 and 2015 in Catalonia was analysed. Among twin pregnancies, 1088 (6.82%) were diagnosed with GDM and 83 (0.52%) had pre-existing diabetes. The prevalence of GDM among twin pregnancies increased from 6.01% in 2006 to 8.48% in 2015 (p < 0.001) and the prevalence of pre-existing diabetes remained stable (from 0.46% to 0.27%, p = 0.416). The risk of pre-eclampsia was higher in pre-existing diabetes (15.66%, p = 0.015) and GDM (11.39%, p < 0.001) than in normoglycaemic twin pregnancies (7.55%). Pre-existing diabetes increased the risk of prematurity (69.62% vs. 51.84%, p = 0.002) and large-for-gestational-age (LGA) infants (20.9% vs. 11.6%, p = 0.001) in twin gestations. An attenuating effect on several adverse perinatal outcomes was found between twin pregnancies and the presence of GDM and pre-existing diabetes. As a result, unlike in singleton pregnancies, diabetes did not increase the risk of all perinatal outcomes in twins and the effect of pre-existing diabetes on pre-eclampsia and LGA appeared to be attenuated. In conclusion, prevalence of GDM among twin pregnancies increased over the study period. Diabetes was associated with a higher risk of pre-eclampsia, prematurity and LGA in twin gestations. However, the impact of both, pre-existing diabetes and GDM, on twin pregnancy outcomes was attenuated when compared with its impact on singleton gestations. Keywords: epidemiology; twins; gestational diabetes; pre-existing diabetes; prevalence; trends; perinatal outcomes Author: Lucia Gortazar, Juana Antonia Flores-Le Roux, David Benaiges, Eugènia Sarsanedas, Humberto Navarro, Antonio Payà, Laura Mañé, Juan Pedro-Botet and Albert Goday Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon May 3 14:16:48 2021 CEST ModDate: Mon May 3 14:21:21 2021 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 817844 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- KORLVE+VnURWPalladioL Type 1 Custom yes yes no 10 0 XWMSYV+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 PWGJBU+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 CEXMDG+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 IXBLAJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 GQWIGS+CMSY10 Type 1 Builtin yes yes no 84 0 JMPEOK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 98 0 JMPEOM+PalatinoLinotype TrueType WinAnsi yes yes no 101 0 JMPEOO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 104 0 JMPEOK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 122 0 JMPEOM+PalatinoLinotype TrueType WinAnsi yes yes no 125 0 JMPEOO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 128 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 136 0 SPXYDX+VnURWPalladioL-Italic Type 1 Custom yes yes no 159 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:19:07 CEST RepresentationInformation: pmc_33946383.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:09:54 CEST Size: 817844 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 352 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Item: Title: Results Destination: section.3 Children: Item: Title: Pregnancy Outcomes of Twin Pregnancies According to Glycaemic Status Destination: subsection.3.1 Item: Title: Interaction between Twin Gestations and Glycaemic Status in Relation to Adverse Perinatal Outcomes Destination: subsection.3.2 Item: Title: Discussion Destination: section.4 Item: Title: References Destination: section.4 Info: Title: Trends in Prevalence of Diabetes among Twin Pregnancies and Perinatal Outcomes in Catalonia between 2006 and 2015: The DIAGESTCAT Study Author: Lucia Gortazar, Juana Antonia Flores-Le Roux, David Benaiges, Eugènia Sarsanedas, Humberto Navarro, Antonio Payà, Laura Mañé, Juan Pedro-Botet and Albert Goday Subject: The aims of our study were to evaluate the trends in the prevalence of diabetes among twin pregnancies in Catalonia, Spain between 2006 and 2015, to assess the influence of diabetes on perinatal outcomes of twin gestations and to ascertain the interaction between twin pregnancies and glycaemic status. A population-based study was conducted using the Spanish Minimum Basic Data Set. Cases of gestational diabetes mellitus (GDM) and pre-existing diabetes were identified using ICD-9-CM codes. Data from 743,762 singleton and 15,956 twin deliveries between 2006 and 2015 in Catalonia was analysed. Among twin pregnancies, 1088 (6.82%) were diagnosed with GDM and 83 (0.52%) had pre-existing diabetes. The prevalence of GDM among twin pregnancies increased from 6.01% in 2006 to 8.48% in 2015 (p < 0.001) and the prevalence of pre-existing diabetes remained stable (from 0.46% to 0.27%, p = 0.416). The risk of pre-eclampsia was higher in pre-existing diabetes (15.66%, p = 0.015) and GDM (11.39%, p < 0.001) than in normoglycaemic twin pregnancies (7.55%). Pre-existing diabetes increased the risk of prematurity (69.62% vs. 51.84%, p = 0.002) and large-for-gestational-age (LGA) infants (20.9% vs. 11.6%, p = 0.001) in twin gestations. An attenuating effect on several adverse perinatal outcomes was found between twin pregnancies and the presence of GDM and pre-existing diabetes. As a result, unlike in singleton pregnancies, diabetes did not increase the risk of all perinatal outcomes in twins and the effect of pre-existing diabetes on pre-eclampsia and LGA appeared to be attenuated. In conclusion, prevalence of GDM among twin pregnancies increased over the study period. Diabetes was associated with a higher risk of pre-eclampsia, prematurity and LGA in twin gestations. However, the impact of both, pre-existing diabetes and GDM, on twin pregnancy outcomes was attenuated when compared with its impact on singleton gestations. 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