Elevated maternal glucose concentrations and placental infection in twin pregnancies.
OBJECTIVE
To evaluate the association between maternal screening glucose concentration and placental infection in nondiabetic twin pregnancies.


METHODS
One thousand sixty-one nondiabetic twin pregnancies at > or =28 weeks' gestation were divided into 3 groups based on the screening 50-g fasting glucose concentration at 24-28 weeks: lowest quartile (< 96 mg/dL), middle 2 quartiles (96-128 mg/dL) and upper quartile (> 128 mg/dL). Outcomes were modeled using general linear and multinomial logistic regression, controlling for confounding factors.


RESULTS
The middle and highest glucose groups were associated with increased risks for clinical chorioamnionitis (adjusted OR [AOR] 3.18, 95% CI 1.34, 7.54; AOR 6.80, CI 1.89, 24.53, respectively). Birth at <32 weeks and histologic diagnosis of placental infection (chorioamnionitis, funisitis, necrosis, vasculitis or villitis) were significantly associated only with the highest glucose group (AOR 1.79, CI 1.02, 3.13; AOR 6.95, CI 1.10, 8.68, respectively).


CONCLUSIONS
Elevated screening glucose in nondiabetic twin pregnancies may be a marker of placental inflammation and infection.
Luke
Barbara
B
Departments of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Florida, USA. b.luke@miami.edu
Brown
Morton B
MB
Misiunas
Ruta B
RB
Mauldin
Jill G
JG
Newman
Roger B
RB
Nugent
Clark
C
Gonzalez-Quintero
Victor H
VH
Witter
Frank R
FR
Hankins
Gary D V
GD
D'Alton
Mary
M
Macones
George A
GA
Grainger
David A
DA
D000328:Adult; D001786:Blood Glucose; D005260:Female; D006801:Humans; D007249:Inflammation; D010922:Placenta Diseases / Q000209:etiology / Q000382:microbiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000209:etiology*; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D012307:Risk Factors
D001786:Blood Glucose