title: Elevated maternal glucose concentrations and placental infection in twin pregnancies.
abstract: 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.
authors.affiliation: Departments of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Florida, USA. b.luke@miami.edu
authors.forename: Barbara
authors.initials: B
authors.lastname: Luke
authors.forename: Morton B
authors.initials: MB
authors.lastname: Brown
authors.forename: Ruta B
authors.initials: RB
authors.lastname: Misiunas
authors.forename: Jill G
authors.initials: JG
authors.lastname: Mauldin
authors.forename: Roger B
authors.initials: RB
authors.lastname: Newman
authors.forename: Clark
authors.initials: C
authors.lastname: Nugent
authors.forename: Victor H
authors.initials: VH
authors.lastname: Gonzalez-Quintero
authors.forename: Frank R
authors.initials: FR
authors.lastname: Witter
authors.forename: Gary D V
authors.initials: GD
authors.lastname: Hankins
authors.forename: Mary
authors.initials: M
authors.lastname: D'Alton
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
authors.forename: David A
authors.initials: DA
authors.lastname: Grainger
mesh_terms: 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
chemical_list: D001786:Blood Glucose