Androgenicity of progestins in hormonal contraceptives and the risk of gestational diabetes mellitus.
- Monique M. Hedderson, PhD (Monique.m.hedderson{at}kp.org)1,,2,
- Assiamira Ferrara, MD, PhD1,,2,
- Michelle A. Williams, ScD2,,3,
- Victoria L. Holt, PhD2,,4 and
- Noel S. Weiss, M.D., DrPH2,,4
- 1Division of Research, Kaiser Permanente Medical Care Program of Northern California, 2000 Broadway Oakland, CA
- 2University of Washington School of Public Health and Community Medicine, Seattle, WA
- 3Center for Perinatal Studies, Swedish Medical Center Seattle, WA
- 4Fred Hutchinson Cancer Research Center, Seattle, WA
Abstract
Objective: There is some evidence that use of hormonal contraceptives (HCs), particularly the more androgenic formulations, can alter a woman's glucose tolerance. We examined the association between HC use, categorized by the androgenicity of the progestin component, and risk of gestational diabetes mellitus (GDM) in a nested case-control study.
Research Design and Methods: Cases (n=356) and controls (n=368) were selected from a multiethnic cohort of 14,235 women who delivered a singleton live birth between January 1, 1996 and June 30, 1998, were screened for GDM at 24-28 gestational weeks and were members of Kaiser Permanente for at least 5 years before pregnancy. GDM was defined using the National Diabetes Data Group plasma glucose cut-offs. Information concerning HC use during the 5 years prior to pregnancy was obtained from the medical charts and some pharmacy data.
Results: There was a suggestion that, compared with no HC use, use of a low-androgen HC before pregnancy was associated with a slight reduction in risk of GDM (OR: 0.84, 95% CI: 0.58-1.22), whereas use of a high-androgen HC was associated with a modest increase in GDM risk (OR: 1.43, 95% CI: 0.92-2.22).
Conclusions: The effects of HC use on GDM risk may vary by the androgenicity of the progestin component.
Footnotes
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- Received October 30, 2006.
- Accepted February 5, 2007.
- Copyright © American Diabetes Association
