Gestational diabetes mellitus in women receiving beta-adrenergics and corticosteroids for threatened preterm delivery.
OBJECTIVE
To determine whether the incidence of gestational diabetes mellitus (GDM) is increased in patients receiving corticosteroids with or without beta-adrenergic agents for threatened preterm delivery.


METHODS
We reviewed the laboratory records of 3396 patients undergoing screening (1-hour glucose) and diagnostic testing (3-hour glucose tolerance test [GTT]) for GDM over 2 years. Patients with antepartum admissions during which they received corticosteroids with or without beta-adrenergic agents for threatened preterm delivery were compared with a control group during the same period. Differences between the study and control groups were analyzed using chi 2, Student t test, or Fisher exact test where appropriate. P < .05 was considered significant.


RESULTS
Fifty patients in the study group were compared with 1985 control patients. The remaining 1361 patients failed to meet inclusion criteria. The overall incidence of diagnosed GDM was significantly greater in the corticosteroid-beta-adrenergic agents study group, in which five (23.8%) of 21 patients screened had abnormal 3-hour GTT results, compared with 79 (4.0%) of 1985 controls (P = .001). One-hour glucose screening test results were abnormal in 60% of the study group compared with 25% of the controls (P < .001).


CONCLUSIONS
Patients treated with beta-adrenergic agents and corticosteroids for threatened preterm delivery are at a significantly increased risk for developing GDM. The high rate of abnormal results in response to the 1-hour glucose screen suggests that this test is of limited value in patients exposed to these medications.
Fisher
J E
JE
Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan.
Smith
R S
RS
Lagrandeur
R
R
Lorenz
R P
RP
D000318:Adrenergic beta-Agonists / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001623:Betamethasone / Q000009:adverse effects*; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000139:chemically induced*; D004359:Drug Therapy, Combination; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D012307:Risk Factors; D013726:Terbutaline / Q000009:adverse effects*
D000318:Adrenergic beta-Agonists; D000893:Anti-Inflammatory Agents; D001623:Betamethasone; D013726:Terbutaline