1191-P: GDM in Twin Pregnancies—Maternal Characteristics and Pregnancy Outcomes

Abstract

The incidence of both gestational diabetes mellitus (GDM) and twin pregnancies have increased over the past two decades. While the same GDM diagnostic criteria and treatment targets are used for singleton and twin pregnancies, data on outcomes for twin pregnancies with GDM are limited. The aim of this retrospective cohort study is to present comprehensive data on maternal characteristics and pregnancy outcomes for individuals with a twin pregnancy who were diagnosed with GDM and attended our center for prenatal care from 2002-22. In total 185 individuals were identified with a mean age of 32 (± 5) years and a mean prepregnancy body mass index of 31.3 (± 7) kg/m2. The majority were dichorionic diamniotic (n=146, 79%), 32 (17%) had a prior diagnosis of GDM and 63 (34%) had prepregnancy fertility treatment. Women underwent universal screening with a 50g glucose challenge test (normal <140mg/dL) and Carpenter and Coustan Criteria were used to diagnose GDM. Pharmacological therapy was required to treat GDM in 68 (37%) cases. Hypertensive disorders of pregnancy were common (n=55, 30%), as was Cesarean delivery (n= 133, 72%). Assessment of pregnancy outcomes (n=370) revealed 360 (97%) livebirths, 8 (2%) stillbirths and 2 (0.6%) neonatal deaths. Among livebirths and neonatal deaths, premature delivery < 37 weeks was recorded in 225 (62.2%) and <34 weeks in 57 (15.7%). Neonatal macrosomia (birthweight >4.0kg) was rare (n=4, 1%), but low birthweight (<2.5kg) occurred in 168 (46%). Neonatal hypoglycemia was documented in 89 (25%) infants. Maternal attendance at the postpartum glucose tolerance test was low (n=47, 25.5%) individuals, and 38 had a subsequent pregnancy with GDM diagnosed in 18 (47%). In summary, the standard GDM diagnostic criteria applied to twin pregnancies identify a maternal cohort at high risk of pregnancy complications and future GDM. Future work should address the optimal nutritional and glycemic goals for this population, particularly considering the high risk of low birthweight and premature neonates. Disclosure D.M.Das: None. A.Vella: Advisory Panel; Rezolute, Inc., Consultant; Crinetics Pharmaceuticals, Inc., Hanmi Pharm. Co., Ltd., Zealand Pharma A/S, Other Relationship; Novo Nordisk. A.M.Egan: None. Funding National Institutes of Health (DK092721, HD065987)