Normal blood sugar levels for twin pregnancy

Q: What is the normal blood sugar level for a pregnant woman with twins?

In twin pregnancy, the ideal cutoff for the glucose challenge test appears to be ≥135 mg/dL,” Nathan S. Fox, MD, of the Icahn School of Medicine at Mount Sinai, told Endocrine Today.

Q: Is diabetes common in twin pregnancy?

Carrying two babies results in higher levels of pregnancy hormones and a higher risk for pregnancy-related complications. This means that gestational diabetes is slightly more common in twin pregnancies. The exact figure varies by source, but one study shows that it is probably about 9%.

Q: Do twins cause low blood sugar?

Significantly higher risk of hypoglycemia (Dextrostix < 40 and < 20 mg%) was found in twins vs singletons (54% vs 32%, OR 2.49, CI 1.77-3.56; 19% vs 8%, OR 2.65, CI 1.59-4.19, respectively). Gestational age of 34-37 weeks increased hypoglycemia risk for the premature twins (77% vs 51%, OR 3.20 CI 1.49-6.88).

Q: What is the Fasting blood sugar level for a pregnant woman?

Target Blood Sugar Levels for Women During Pregnancy The American Diabetes Association recommends these targets for pregnant women who test their blood sugar: Before a meal: 95 mg/dL or less. An hour after a meal: 140 mg/dL or less. Two hours after a meal: 120 mg/dL or less.

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Original ResearchObstetricsGestational diabetes and fetal growth in twin compared with singleton pregnancies
Study Design
Cited by (0)
Study Design
Article Info
Publication History
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What is the normal blood sugar level for a pregnant woman with twins?
Is diabetes common in twin pregnancy?
Do twins cause low blood sugar?
What is the Fasting blood sugar level for a pregnant woman?

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Original ResearchObstetricsGestational diabetes and fetal growth in twin compared with singleton pregnancies

Background

Gestational diabetes mellitus is associated with accelerated fetal growth in singleton pregnancies but may affect twin pregnancies differently because of the slower growth of twin fetuses during the third trimester of pregnancy and their greater predisposition to fetal growth restriction.

Objective

This study aimed to evaluate the association of gestational diabetes mellitus with longitudinal fetal growth in twin pregnancies and to compare this association with that observed in singleton pregnancies.

Study Design

This was a retrospective cohort study of all women with a singleton or twin pregnancy who were followed up at a single tertiary referral center between January 2011 and April 2020. Data on estimated fetal weight and individual fetal biometric indices were extracted from ultrasound examinations of eligible women. Generalized linear models were used to model and compare the change in fetal weight and individual biometric indices as a function of gestational age between women with and without gestational diabetes mellitus in twin pregnancies and between women with and without gestational diabetes mellitus in singleton pregnancies. The primary outcome was estimated fetal weight as a function of gestational age. The secondary outcomes were longitudinal growth of individual fetal biometric indices and the rate of small for gestational age and large for gestational age at birth.

Results

A total of 26,651 women (94,437 ultrasound examinations) were included in the analysis: 1881 with a twin pregnancy and 24,770 with a singleton pregnancy. The rate of gestational diabetes mellitus in the twin and singleton groups was 9.6% (n=180) and 7.6% (n=1893), respectively. The estimated fetal weight in singleton pregnancies with gestational diabetes mellitus was significantly higher than that in pregnancies without gestational diabetes mellitus (P<.001) starting at approximately 30 weeks of gestation. The differences remained similar after adjusting for maternal age, chronic hypertension, nulliparity, and neonatal sex (P<.001). In twin pregnancies, fetal growth was similar between pregnancies with and without gestational diabetes mellitus (P=.105 and P=.483 for unadjusted and adjusted models, respectively). The findings were similar to the association of gestational diabetes mellitus with the risk of large for gestational fetuses and the growth of each biometric index. When stratified by type of gestational diabetes mellitus treatment, twin pregnancies with gestational diabetes mellitus was associated with accelerated fetal growth only in the subgroup of women with medically treated gestational diabetes mellitus (P<.001), which represented 12% (n=21) of the twin pregnancy group with gestational diabetes mellitus.

Conclusion

In contrast to singleton pregnancies, twin pregnancies with gestational diabetes mellitus is less likely to be associated with accelerated fetal growth. This finding has raised the question of whether the diagnostic criteria for gestational diabetes mellitus and the blood glucose targets in women diagnosed with gestational diabetes mellitus should be individualized for twin pregnancies.

Key words

gestational diabetes mellitus

growth

macrosomia

large for gestational age

multifetal pregnancy

twin pregnancy

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Background

Objective

Study Design

Results

Conclusion

Key words

gestational diabetes mellitus
growth
macrosomia
large for gestational age
multifetal pregnancy
twin pregnancy

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Article Info

Publication History

Published online: April 16, 2021

Accepted: April 9, 2021

Received in revised form: March 11, 2021

Received: December 28, 2020

Footnotes

The authors report no conflict of interest.

Cite this article as: Ashwal E, Berger H, Hiersch L, et al. Gestational diabetes and fetal growth in twin compared with singleton pregnancies. Am J Obstet Gynecol 2021;225:420.e1-13.

Identification

DOI: https://doi.org/10.1016/j.ajog.2021.04.225

Copyright

ScienceDirect

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What is the normal blood sugar level for a pregnant woman with twins?

“In twin pregnancy, the ideal cutoff for the glucose challenge test appears to be ≥135 mg/dL,” Nathan S. Fox, MD, of the Icahn School of Medicine at Mount Sinai, told Endocrine Today.

Is diabetes common in twin pregnancy?

Carrying two babies results in higher levels of pregnancy hormones and a higher risk for pregnancy-related complications. This means that gestational diabetes is slightly more common in twin pregnancies. The exact figure varies by source, but one study shows that it is probably about 9%.

Do twins cause low blood sugar?

Significantly higher risk of hypoglycemia (Dextrostix < 40 and < 20 mg%) was found in twins vs singletons (54% vs 32%, OR 2.49, CI 1.77-3.56; 19% vs 8%, OR 2.65, CI 1.59-4.19, respectively). Gestational age of 34-37 weeks increased hypoglycemia risk for the premature twins (77% vs 51%, OR 3.20 CI 1.49-6.88).

What is the Fasting blood sugar level for a pregnant woman?

Target Blood Sugar Levels for Women During Pregnancy The American Diabetes Association recommends these targets for pregnant women who test their blood sugar: Before a meal: 95 mg/dL or less. An hour after a meal: 140 mg/dL or less. Two hours after a meal: 120 mg/dL or less.