{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:27:50Z","timestamp":1784366870100,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["Women's Reproductive Health Research K12 HD10308"],"award-info":[{"award-number":["Women's Reproductive Health Research K12 HD10308"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["1R01 DK128187\u201001A1"],"award-info":[{"award-number":["1R01 DK128187\u201001A1"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["6R01DK089201"],"award-info":[{"award-number":["6R01DK089201"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>There is an increasing incidence of pregnancies with twin gestations. One outcome more likely to occur with multiple gestations is gestational diabetes mellitus. Studies have suggested that in singleton pregnancies, fetal sex may affect insulin resistance. However, the effects of fetal sex in twins and the development of gestational diabetes mellitus are unknown. We hypothesized that rates of gestational diabetes mellitus and degree of insulin resistance might vary in twin gestations based on the fetal sex pairing: male\u2013male, male\u2013female or female\u2013female. We aimed to employ a large population\u2010based database to ascertain any correlations between fetal sex and gestational diabetes mellitus in multifetal gestations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A two\u2010hospital, single academic institution database comprised of over 39\u2009000 participants with pregnancy data from August 2011 to January 2022 was employed. All twin deliveries of live\u2010born neonates &gt;24\u2009weeks\u2019 gestational age from gravidae without preexisting diabetes or twin\u2013twin transfusion syndrome were included. Entries were then grouped based on the fetal sex of the pairing. The presence or absence of gestational diabetes and type of gestational diabetes \u2013 diet\u2010controlled (gestational diabetes mellitus classification A1) vs medication\u2010controlled (gestational diabetes mellitus classification A2) \u2013 were identified. Statistical analysis was performed using a generalized linear mixed method, and a <jats:italic>P<\/jats:italic>\u2010value \u22640.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 1924 twin deliveries that met the inclusion criteria in our database (male\u2013male =652; male\u2013female\u2009=\u2009638; female\u2013female\u2009=\u2009634). We found no association between fetal sex pairing and the development of gestational diabetes mellitus. There was a significant association between the fetal sex pairing and the type of gestational diabetes mellitus developed, with 32.0% of male\u2013male twins, 33.3% of male\u2013female twins and 58.3% of the female\u2013female twin deliveries associated with medication\u2010controlled gestational diabetes classification A2: male\u2013female vs female\u2013female (<jats:italic>P<\/jats:italic>\u2009=\u20090.05) and male\u2013male vs female\u2013female (<jats:italic>P<\/jats:italic>\u2009=\u20090.046).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While gestational diabetes mellitus is of multifactorial origin, we found a significant association between the fetal sex pairing and the treatment needed for gravidae with twins who develop gestational diabetes mellitus. A higher proportion of female\u2013female twins was associated with gestational diabetes classification A2 compared with male\u2013female or male\u2013male deliveries. Further research on the physiology driving this association is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14625","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T06:43:31Z","timestamp":1696315411000},"page":"1703-1710","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fetal sex and the development of gestational diabetes mellitus in gravidae with multiple gestation pregnancies"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3457-5318","authenticated-orcid":false,"given":"Alexa M.","family":"Sassin","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haleh","family":"Sangi\u2010Haghpeykar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2960-0371","authenticated-orcid":false,"given":"Kjersti M.","family":"Aagaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine, and Departments of Molecular and Human Genetics Molecular and Cell Biology, and Molecular Physiology and Biophysics, Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep004"},{"key":"e_1_2_12_3_1","unstructured":"National Vital Statistics Reports.Data obtained via Human Multiple Births Database 2023. 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