Endocrine Abstracts

Introduction: In singleton pregnancies, gestational diabetes mellitus (GDM) results in an increased risk for maternal and neonatal complications. In twin pregnancies, however, the effect of GDM on maternal and neonatal complications appears to be different in comparison to singletons. The few studies that investigated the consequences of GDM in twin pregnancies are small and present conficting evidence, with some finding no difference in perinatal outcomes between GDM and non-GDM twins and others even demonstrating better outcomes.

Objetive: To Compare maternal and fetal outcomes in pregnant women with and without GDM in a twin pregnancy.

Methods: Observational and retrospective study comparing maternal and fetal outcomes in 42 women having a twin pregnancy complicated with GDM followed in a Portuguese tertiary hospital whose deliveries occurred between 2011 and 2018, with 83 pregnant women with twin pregnancies without GDM whose delivery occurred in 2018.

Results: There was no difference in maternal mean age (32.7 ± 4.8 vs 32.8 ± 4.8 years-old, P = 0.936) and in fertility treatment rate (45.2% vs 34.9%, P = 0.114), in both groups. The pre-pregnancy IMC and percentage of excessive weight gain was higher in the GDM group, with 24.9 (IQR: 22.4–28.5) vs 23.8 (IQR: 21.2–25.5) kg/m², P = 0.007 and 10.7% vs 0%, P = 0.005, respectively. No difference between the groups was found for: abortion rates, hydramnios, fetal death, chorionicity, induced and chronic hypertension. The GDM group it seems to had a higher risk of having preeclampsia, but without statistical significance (14.3% vs 7.2%, P = 0.074). Regarding fetal outcomes, no difference was found between the two groups for hypoglycemia, hyperbilirubinemia, respiratory distress syndrome (RDS), NICU admission, birth trauma or neonatal death rates. Both groups presented a high prematurity rate (73.8% vs 72.3%, P = 0.799, with and without GDM, respectively). There was a higher prevalence ofsmall for gestational age (SGA) babies in the group without GDM (40% vs 27.4%, P = 0.049). None of groups had newborns with macrosomia or large for gestacional age (LGA).

Conclusion: There was no difference between maternal outcomes in twin pregnancy with or without GDM. Nevertheless, and although the results were not significant, the group with GDM had a higher prevalence of preeclampsia, as described in other studies. Twin pregnancy complicated with GDM is not associated with neonatal morbidity occurrence, characteristic of the newborn from a diabetic mother observed in singleton pregnancy and this diagnosis seems to be protective for SGA occurrence.