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Published online June 11, 2007
Diabetes Care 30:2277-2280, 2007
DOI: 10.2337/dc07-0564
© 2007 by the American Diabetes Association
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Epidemiology/Health Services Research
Original Article

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

Andrei Rebarber, MD1, Niki B. Istwan, RN2, Karen Russo-Stieglitz, MD3, Jane Cleary-Goldman, MD1, Debbie J. Rhea, MPH2, Gary J. Stanziano, MD2 and Daniel H. Saltzman, MD1

1 Mount Sinai School of Medicine, Division of Maternal Fetal Medicine, New York, New York
2 Matria Healthcare, Department of Clinical Research, Marietta, Georgia
3 Valley Health System, Division of Maternal Fetal Medicine, Ridgewood, New Jersey

Address correspondence and reprint requests to Andrei Rebarber, MD, 70 E. 90th St., New York, NY 10029. E-mail: arebarber{at}mfmnyc.com

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 17{alpha}-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.

Abbreviations: 17P, 17{alpha}-hydroxyprogesterone caproate • ADA, American Diabetes Association • GDM, gestational diabetes mellitus


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