title: Outcome of twin pregnancies associated with glucose intolerance.
abstract: OBJECTIVE
  There is little information about the impact of hyperglycaemia in twin pregnancies. The objective of our study was to evaluate the maternal, foetal and neonatal complications in patients with twin pregnancy and glucose intolerance defined by gestational diabetes mellitus and gestational mild hyperglycaemia.
  
  
  METHODS
  We performed a single-centre retrospective study. Screening for gestational diabetes was achieved by a two-step method. Patients were managed according to the French guidelines. After matching for age and body mass index, outcomes were compared in 177 patients with glucose intolerance and 509 controls. Macrosomia was defined as birth weight above the 90th percentile of gestational age adjusted for parity, foetal sex and maternal biometrics.
  
  
  RESULTS
  Prevalence of glucose intolerance was 17.5% in our population. Complications of pregnancy and mode of delivery were similar between the two groups. Caesarean section was associated with age >35 years, vascular complications of pregnancy and non-cephalic presentation of the first twin. Rate of macrosomia was not different between the two groups. The only risk factor for macrosomia was a history of macrosomia in a previous pregnancy (odds ratio = 5.9, 95% confidence interval = 1.8-19.2).
  
  
  CONCLUSIONS
  Twin pregnancies complicated by glucose intolerance were not associated with an increased risk of macrosomia or Caesarean section. Further studies should assess the value of screening gestational diabetes mellitus in twin pregnancies.
authors: GEM-JDF Project, Pôle femme, mère, nouveau-né, Maternité Jeanne-de-Flandre, CHRU de Lille, Lille, France.
authors: C
authors: C
authors: Poulain
authors: Department of biostatistics, EA2694, Faculté de médecine Henri-Warembourg, Université Lille 2, PRES Lille Nord de France, Lille, France.
authors: A
authors: A
authors: Duhamel
authors: GEM-JDF Project, Pôle femme, mère, nouveau-né, Maternité Jeanne-de-Flandre, CHRU de Lille, Lille, France; UPRES EA 4489, Environnement périnatal et croissance, Faculté de médecine Henri-Warembourg, Université Lille 2, PRES Lille Nord de France, Lille, France.
authors: C
authors: C
authors: Garabedian
authors: Pôle médico-chirurgical, Hôpital Huriez, CHRU de Lille, Lille, France.
authors: M
authors: M
authors: Cazaubiel
authors: Pôle médico-chirurgical, Hôpital Huriez, CHRU de Lille, Lille, France.
authors: M C
authors: MC
authors: Rejou
authors: Pôle médico-chirurgical, Hôpital Huriez, CHRU de Lille, Lille, France; UPRES EA 4489, Environnement périnatal et croissance, Faculté de médecine Henri-Warembourg, Université Lille 2, PRES Lille Nord de France, Lille, France.
authors: A
authors: A
authors: Vambergue
authors: GEM-JDF Project, Pôle femme, mère, nouveau-né, Maternité Jeanne-de-Flandre, CHRU de Lille, Lille, France; UPRES EA 4489, Environnement périnatal et croissance, Faculté de médecine Henri-Warembourg, Université Lille 2, PRES Lille Nord de France, Lille, France. Electronic address: philippe.deruelle@univ-lille2.fr.
authors: P
authors: P
authors: Deruelle
mesh_terms: D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D059285:Pregnancy, Twin; D011296:Prenatal Diagnosis; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Gestational diabetes mellitus; Obstetrics; Pregnancy; Twin studies