title: Obstetric and perinatal outcome in women with twin pregnancy and gestational diabetes.
abstract: OBJECTIVE
  The aim of this study was to evaluate pregnancy complications and obstetric and perinatal outcomes in women with twin pregnancy and GDM. STUD DESIGN: An observational multicentre retrospective study was performed and 534 pregnant woman and 1068 twins infants allocated into two groups, 257 with GDM and 277 controls, were studied.
  
  
  METHODS
  Pregnant women characteristics, hypertensive complications, preterm delivery rate, mode of delivery and birthweight were analysed.
  
  
  RESULTS
  Pregnant women with GDM were older (p < 0.001) and had higher body mass index (p < 0.001) than controls. GDM was associated with higher risk of prematurity in twin pregnancy (odds ratio 1.64, 95% confidence interval [1.14-2.32], p = 0.005). This association was based on the association with other pregnancy complications. Birthweight Z-scores were significantly higher in the GDM group (p = 0.02). The rate of macrosomia was higher in the GDM group (p = 0.002) and small for gestational age (SGA) babies were significantly less frequent (p = 0.03). GDM was an independent predictor of macrosomia (p = 0.006).
  
  
  CONCLUSIONS
  The presence of GDM in twin pregnancy was associated with a higher risk of hypertensive complications, prematurity and macrosomia, but significantly reduces the risk of SGA infants. Prematurity was related to the presence of other associated pregnancy complications.
authors.affiliation: Fisiopatología Fetal, 2ª pta policlínica, Hospital Universitario de Canarias, Tenerife, Spain. ngonzalezg@sego.es
authors.forename: Nieves L
authors.initials: NL
authors.lastname: González González
authors.forename: María
authors.initials: M
authors.lastname: Goya
authors.forename: Jordi
authors.initials: J
authors.lastname: Bellart
authors.forename: Jose
authors.initials: J
authors.lastname: Lopez
authors.forename: Maria A
authors.initials: MA
authors.lastname: Sancho
authors.forename: Juan
authors.initials: J
authors.lastname: Mozas
authors.forename: Victoria
authors.initials: V
authors.lastname: Medina
authors.forename: Erika
authors.initials: E
authors.lastname: Padrón
authors.forename: Ana
authors.initials: A
authors.lastname: Megia
authors.forename: Pilar
authors.initials: P
authors.lastname: Pintado
authors.forename: Juan C
authors.initials: JC
authors.lastname: Melchor
authors.forename: Gian C
authors.initials: GC
authors.lastname: Di Renzo
authors.forename: José L
authors.initials: JL
authors.lastname: Bartha
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology