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Diabetes Care Publish Ahead of Print published online ahead of print June 11, 2007
DOI: 10.2337/dc07-0564
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Original Research

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

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

arebarber{at}mfmnyc.com

ABSTRACT

OBJECTIVE:Progesterone has a known diabetogenic effect. We sought to determine if the incidence of gestational diabetes (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 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 pre-existing diabetes were excluded. The incidence of GDM was compared between patients receiving prophylactic intramuscular 17P (250mg weekly injection initiated between 16.0 and 20.9 weeks gestation) and those that did not.

RESULTS:Maternal body-mass-index and age were similar. The incidence of GDM was 12.9% in the 17P group (n=557) compared with 4.9% in controls (n=1524), p<0.001; Odds Ratio (95% CI) 2.9 (2.1, 4.1).

CONCLUSION: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.


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Copyright © 2007 by the American Diabetes Association.