Analysis of the main risk factors for gestational diabetes diagnosed with International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria in multiple pregnancies.
BACKGROUND
The aim is to investigate the proportion of multiple pregnancies with gestational diabetes mellitus (GDM) diagnosed using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and to identify the impact of age, body mass index (BMI), and mode of conception on incidence of GDM.


METHODS
This is a single center, retrospective cohort study on 656 multiple pregnancies screened for GDM with 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation, between January 2010 and January 2016. The diagnosis of gestational diabetes mellitus (GDM) was reached through the IADPSG.


RESULTS
The incidence of GDM in our population was 15.1%. When patients who conceived through heterologous assisted reproduction technology were compared with those who conceived spontaneously, there was a significant difference for GDM (31.1 vs 13.6%, p < 0.001, OR 2.86). A similar finding was also observed comparing egg donation IVF/ICSI patients with homologous IVF/ICSI patients (31.1 vs 14.8%, p = 0.006, OR 2.59). Incidence of GDM was significantly higher in obese than in non-obese patients (42.5 vs 14.8%, p < 0.001, OR 4.88) and in women over 35 compared to younger patients (18.4 vs 11.1%, p = 0.01, OR 1.81). Logistic regression comparing the diabetes onset with conception mode gave a p = 0.07. The calculation of the Chi-square and odds ratio for single mode of conception showed that homologous vs conceived spontaneously p = 0.90, OR 0.97, heterologous vs homologous p = 0.01 with OR 2.46, and heterologous vs conceived spontaneously p = 0.01 with OR 2.39. Logistic regression showed that age and BMI are risk factors for developing GDM, respectively, p = 0.03 with OR 1.4 and p < 0.01 and OR 1.09.


CONCLUSIONS
The contribution our study can make is improved counseling about GDM risks for couples with multiple pregnancies. Our data support the role of age, BMI, and mode of conception as risk factors for GDM in multiple pregnancies.
Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and Gynaecology, University of Florence, Florence, Italy. maurocoz@yahoo.it.
M
M
Cozzolino
Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy.
C
C
Serena
Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy.
L
L
Maggio
Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy.
M P
MP
Rambaldi
Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy.
S
S
Simeone
Department of Sciences for the Health of Women and Children, Careggi Hospital, University of Florence, Florence, Italy.
G
G
Mello
Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy.
L
L
Pasquini
Department of Sciences for the Health of Women and Children, Careggi Hospital, University of Florence, Florence, Italy.
M
M
Di Tommaso
Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy.
F
F
Mecacci
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D038622:Internationality; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000502:physiology*; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors
Assisted reproduction technology; Gestational diabetes mellitus; IADPSG criteria; Multiple pregnancies