ArticleBMJ open2026
Association between gestational diabetes mellitus and maternal and neonatal outcomes in twin pregnancies: a retrospective cohort study in Guangdong, China.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn singleton pregnancies, gestational diabetes mellitus (GDM) causes maternal and neonatal complications. However, this association remains unclear in twin pregnancies. This study aimed to investigate the association between GDM and obstetric outcomes specifically in twin pregnancies.
methodsA retrospective cohort study was conducted among women with twin pregnancies from January 2018 to July 2022. Maternal and neonatal outcomes were compared between women with and without GDM. Adjusted ORs, 95% CIs and SEs were estimated using logistic regression, adjusting for maternal age, prepregnancy body mass index and chorionicity.
resultsA total of 808 women (1616 neonates) were included in the study, of whom 178 had GDM, while 630 did not. GDM was found to be positively associated with (adjusted OR, (95% CI)) preterm birth (1.73 (1.17 to 2.54)), premature rupture of membranes (1.70 (1.03 to 2.79)) and hypothyroidism (2.58 (1.46 to 4.56)) in women with twin pregnancies. In regard to neonatal outcomes, GDM was positively associated with admission to neonatal ward (1.49 (1.13 to 1.96)), oxygen therapy (1.91 (1.45 to 2.52)), hyperbilirubinaemia (1.44 (1.08 to 1.90)), total use and prophylactic use of antibiotics (1.98 (1.17 to 3.33) and 1.88 (1.00 to 3.54), respectively). When stratified by gestational age, GDM remained positively associated with certain adverse outcomes exclusively in twin preterm infants.
conclusionsOur study demonstrated that GDM is significantly associated with several adverse pregnancy outcomes in twin pregnancies, including hypothyroidism in pregnant women, preterm birth, admission to neonatal ward, oxygen therapy, hyperbilirubinaemia, the total and prophylactic use of antibiotics in twins. Specifically, in twin pregnancies, GDM may be more strongly associated with adverse outcomes in preterm infants than in term infants.
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