Desenlaces maternos y perinatales asociados con embarazo múltiple en pacientes con diabetes gestacional

OBJECTIVE: To evaluate and compare the association between gestational diabetes and adverse maternal-perinatal outcomes in patients with multiple pregnancies. MATERIALS AND METHODS: Retrospective cohort study, undertaken in patients with twin pregnancy, without diagnosed comorbidities, admitted to a reference center in Medellín, Colombia, from January 2013 to January 2017. Maternal and perinatal outcomes were compared until discharge of the newborn of mothers with and without gestational diabetes. For statistical analysis, crude and adjusted associations were estimated. RESULTS: A total of 87 patients with twin pregnancies were registered: 35 vs 52 with and without gestational diabetes, respectively, among 228 twin pregnancies attended in the study period. Overweight/obesity predominated in both groups (n = 30 of 35) vs (n = 35 of 52); p = 0.112. The variables: primigravida, history of gestational diabetes and macrosomia were significantly more frequent in the gestational diabetes group (p < 0.05). The median gestational age at diagnosis was 27 weeks (interquartile range between 24.3-30). No statistically significant differences were found in the maternal outcomes of both groups. The gestational age at delivery was 35 weeks in both groups (RR: 0.01; -0.90-0.92; p = 0.980). Neonatal deaths were only recorded in the group of pregnant women without gestational diabetes (n = 52 of 87), in 3 (2.9%) of the 104 live births. Birth weight was similar in both groups; However, pregnant women with gestational diabetes had a higher risk of transient tachypnea than the control group (RR: 2.06; 95%CI: 1.08-3-92), even after adjusting for birth weight (RR: 2.59; 95%CI: 1.35-4.57). Gestational diabetes was an independent risk factor for hydroelectrolyte disorders, especially potassium disorders (RR: 8.09; 95%CI: 1.60-41.01). CONCLUSIONS: Gestational diabetes in women with twin pregnancies is not a factor that, in general, worsens adverse maternal and perinatal outcomes.