Gestational diabetes mellitus in twin pregnancies is not associated with adverse perinatal outcomes.
OBJECTIVE
To investigate the influence of gestational diabetes mellitus (GDM) on maternal and neonatal outcomes in twin pregnancies.


METHODS
A retrospective population-based study was conducted, comparing maternal and neonatal outcome in women carrying twins with and without GDM. Deliveries occurred in a tertiary medical center between the years 1988 and 2010. Multivariable analysis was used to control for confounders.


RESULTS
The study population included 4,428 twin pregnancies, of these 341 (7.7 %) were complicated with GDM. Twin pregnancies complicated with GDM had higher rates of fertility treatment, chronic hypertension, preeclampsia and cesarean deliveries (CD). Nevertheless, using a multivariable analysis, with CD as the outcome variable, controlling for confounders such as maternal age, fertility treatments and hypertensive disorders, GDM in twins was not found to be an independent risk factor for CD (adjusted OR = 1.8, 95 % CI 0.9-1.4; P = 0.18). Rates of low 5 min Apgar scores (<7) and perinatal mortality were lower among twins with GDM (2.9 % vs. 5.3 %, OR = 0.5, 95 % CI 0.3-0.8 0; P = 0.005 and 2.3 % vs. 4.4 %, OR = 0.5, 95 % CI 0.3-0.8; P = 0.005, respectively).


CONCLUSIONS
In our population, GDM in twin pregnancies was not associated with increased rates of adverse perinatal outcomes. In addition, GDM was not found to be an independent risk factor for CD in twin pregnancies.
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer Sheva, Israel, okby@bgu.ac.il.
Rania
R
Okby
Adi Y
AY
Weintraub
Ruslan
R
Sergienko
Sheiner
S
Eyal
D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D007751:Labor, Induced / Q000706:statistics & numerical data; D008423:Maternal Age; D015999:Multivariate Analysis; D010298:Parity; D054238:Perinatal Mortality; D006831:Polyhydramnios / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology; D059285:Pregnancy, Twin; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012189:Retrospective Studies