Concurrence of gestational diabetes and pre-gravid obesity ("diabesity") in twin gestations
Teresinha Simões1, Alexandra Queirós1, Sandra Valdoleiros1
1a Department of Maternal-Fetal Medicine Maternity Dr. Alfredo da Costa , Centro Hospitalar Lisboa Central and Universidade Nova de Lisboa , Lisbon , Portugal.
Objective:
To assess the effect of the concurrence of gestational diabetes mellitus (GDM) and pre-gravid obesity in twin gestations ("diabesity").
Methods:
We compared perinatal outcomes of twin gestation in mothers with GDM and pre-gravid obesity (1.7%), mothers with GDM but with normal BMI (6.2%), and obese mothers without GDM (7.0%).
Results:
Twin pregnancies with "diabesity" were associated with significantly higher incidence of stillbirth (OR = 6.4; 95%CI = 1.4, 33.4) and existing chronic hypertension (OR = 4.2; 95%CI = 1.2, 14.8) than in GDM pregnancies without obesity, and with births at 33-36 weeks as compared with the other groups. Otherwise, the comparisons showed remarkable similar results in terms of gestational age, birth weight, preeclampsia, cesarean section rate, and fetal-neonatal outcomes.
Conclusion:
It appears that diabesity has a relatively minor effect in twins. If this will be confirmed by other studies, it would be important to elucidate how twins ameliorate the adverse outcomes of diabesity.
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