title: Gestational diabetes mellitus in women with multiple pregnancies: is the metabolic abnormality milder?
abstract: OBJECTIVE
  We aimed to compare maternal characteristics and dysglycemia after delivery in women with gestational diabetes mellitus (GDM) according to pregnancy being multiple (MP) or singleton (SP). The hypothesis was that women with GDM and MP would have a milder glycemic abnormality before and after pregnancy than those with SP.
  
  
  METHODS
  We performed a cohort study of 2908 women giving birth between 1986 and 2009. Logistic regression was performed to discriminate between MP and SP after anamnestic pre-pregnancy characteristics. Kaplan-Meier and Cox regression analyses were performed to assess if MP was independently associated with both impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) and diabetes after delivery.
  
  
  RESULTS
  Family history of diabetes was the only independent anamnestic pre-pregnancy characteristic discriminating MP versus SP, OR 2.04 (95% CI 1.12, 3.70, p 0.019). The median time to progress to IFG/IGT was 7.52 years in SP (95% CI 6.92, 8.13) and 7.41 in MP (95% CI 3.84, 10.98), ns and the progression to DM did not differ. In addition, MP was not associated to IFG/IGT or to DM in the Cox regression analysis.
  
  
  CONCLUSIONS
  In this cohort of women with GDM, those with MP did not demonstrate a lesser degree of dysglycemia after controlling for other pregnancy characteristics and pregnancy-independent factors.
authors.affiliation: a Department of Endocrinology and Nutrition , Hospital De La Santa Creu I Sant Pau , Barcelona , Spain .
authors.forename: F
authors.initials: F
authors.lastname: Caimari
authors.affiliation: a Department of Endocrinology and Nutrition , Hospital De La Santa Creu I Sant Pau , Barcelona , Spain .
authors.forename: A
authors.initials: A
authors.lastname: Ramos
authors.affiliation: a Department of Endocrinology and Nutrition , Hospital De La Santa Creu I Sant Pau , Barcelona , Spain .
authors.forename: I
authors.initials: I
authors.lastname: Pujol
authors.affiliation: a Department of Endocrinology and Nutrition , Hospital De La Santa Creu I Sant Pau , Barcelona , Spain .
authors.forename: A
authors.initials: A
authors.lastname: García-Patterson
authors.affiliation: b Department of Gynecology and Obstetrics , Hospital De La Santa Creu I Sant Pau , Barcelona , Spain .|c Department of Pediatrics , Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma De Barcelona , Bellaterra , Spain .|d Department of Medicine , Universitat Autònoma De Barcelona , Bellaterra , Spain , and.
authors.forename: J M
authors.initials: JM
authors.lastname: Adelantado
authors.affiliation: a Department of Endocrinology and Nutrition , Hospital De La Santa Creu I Sant Pau , Barcelona , Spain .|d Department of Medicine , Universitat Autònoma De Barcelona , Bellaterra , Spain , and.|e CIBER Bioengineering, Biomaterials and Nanotechnology (CIBER-BBN), Instituto De Salud Carlos III , Madrid , Spain.
authors.forename: R
authors.initials: R
authors.lastname: Corcoy
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000378:metabolism*; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D001786:Blood Glucose
keywords: Diabetes mellitus; impaired fasting glucose; impaired glucose tolerance; postpartum glucose tolerance; singleton pregnancy; survival analysis