Incidence of gestational diabetes in multifetal gestations

Objective: The objective of this study was to determine if there is an increased incidence of glucose intolerance in multifetal pregnancies. Methods: All multifetal gestations delivered at the University Hospital at Stony Brook between January 1990 and April 1993 were entered in this study. A maternal age-matched singleton control group was identified. All patients participated in universal screening for diabetes between 24 and 28 weeks of gestation. None of the study or control patients had a history of pregestational diabetes. Patients who were administered steroids to enhance fetal lung maturity and β-agonists for premature labor were excluded. Screening was achieved by administering a 50-g oral glucose load followed by venous blood glucose sampling 1 h later. If the resulting glucose level was 140 mg/dl or greater the patient underwent a 3-h glucose tolerance test. A diagnosis of gestational diabetes was then made according to the criteria of the American Diabetes Association. Results: Using American Diabetes Association criteria, this study showed an 8.6% (12/140) incidence of gestational diabetes in multifetal pregnancy compared with 2.8% (4/ 140) in singletons. The difference was statistically significant (P < .05). Conclusions: There is an increased incidence of gestational diabetes in multifetal gestations. This suggests that routine screening for diabetes in multifetal gestations should be performed.