Increased Incidence of Gestational Diabetes in Women Receiving Prophylactic 17α-Hydroxyprogesterone Caproate for Prevention of Recurrent Preterm Delivery

• Published in: Diabetes care Vol. 30; no. 9; pp. 2277 - 2280
• Main Authors: Rebarber, Andrei, Istwan, Niki B, Russo-Stieglitz, Karen, Cleary-Goldman, Jane, Rhea, Debbie J, Stanziano, Gary J, Saltzman, Daniel H
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.09.2007
• Subjects: Biological and medical sciences; body mass index; Complications and side effects; Diabetes in pregnancy; Diabetes. Impaired glucose tolerance; disease control; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; gestational diabetes; hexanoic acid; Hydroxyprogesterone; Medical sciences; Metabolic diseases; Miscellaneous; nursing care; odds ratio; patients; pregnancy outcome; premature birth; progesterone; Public health. Hygiene; Public health. Hygiene-occupational medicine; risk; Risk factors; screening; women; Human; Relapse; Pregnancy disorders; Nutrition; Hydroxyprogesterone caproate; Premature delivery; Metabolic diseases; Recurrent; Maternal diseases; Epidemiology; Incidence; Prevention; Prematurity; Adult; Female; Gestational diabetes; Woman; Endocrinology
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc07-0564

OBJECTIVE:--Progesterone has a known diabetogenic effect. We sought to determine whether the incidence of gestational diabetes mellitus (GDM) is altered in women receiving weekly 17α-hydroxyprogesterone caproate (17P) prophylaxis for the prevention of recurrent preterm birth. RESEARCH DESIGN AND METHODS--Singleton gestations in women having a history of preterm delivery were identified from a database containing prospectively collected information from women receiving outpatient nursing services related to a high-risk pregnancy. Included were patients enrolled for outpatient management at <27 weeks' gestation with documented pregnancy outcome and delivery at >28 weeks. Patients with preexisting diabetes were excluded. The incidence of GDM was compared between patients who received prophylactic intramuscular 17P (250-mg weekly injection initiated between 16.0 and 20.9 weeks' gestation) and those who did not. RESULTS:--Maternal BMI and age were similar. The incidence of GDM was 12.9% in the 17P group (n = 557) compared with 4.9% in control subjects (n = 1,524, P < 0.001; odds ratio 2.9 [95% CI 2.1-4.1]). CONCLUSIONS:--The use of 17P for the prevention of recurrent preterm delivery is associated with an increased risk of developing GDM. Early GDM screening is appropriate for women receiving 17P prophylaxis.