title: Androgenicity of progestins in hormonal contraceptives and the risk of gestational diabetes mellitus.
abstract: OBJECTIVE
  There is some evidence that use of hormonal contraceptives, particularly the more androgenic formulations, can alter a woman's glucose tolerance. We examined the association between hormonal contraceptive use, categorized by the androgenicity of the progestin component, and risk of gestational diabetes mellitus (GDM) in a nested case-control study.
  
  
  METHODS
  Case (n = 356) and control (n = 368) subjects were selected from a multiethnic cohort of 14,235 women who delivered a singleton live birth between 1 January 1996 and 30 June 1998, who were screened for GDM at 24-28 gestational weeks, and who were members of Kaiser Permanente for at least 5 years before pregnancy. GDM was defined using the National Diabetes Data Group plasma glucose cutoffs. Information concerning hormonal contraceptive use during the 5 years before pregnancy was obtained from medical charts and some pharmacy data.
  
  
  RESULTS
  There was a suggestion that compared with no hormonal contraceptive use, use of a low-androgen hormonal contraceptive before pregnancy was associated with a slight reduction in risk of GDM (odds ratio 0.84 [95% CI 0.58-1.22]), whereas use of a high-androgen hormonal contraceptive was associated with a modest increase in GDM risk (1.43 [0.92-2.22]).
  
  
  CONCLUSIONS
  The effects of hormonal contraceptive use on GDM risk may vary by the androgenicity of the progestin component.
authors.affiliation: Division of Research, The Kaiser Permanente Medical Group, 2000 Broadway, Oakland, CA, USA. monique.m.hedderson@kp.org
authors.forename: Monique M
authors.initials: MM
authors.lastname: Hedderson
authors.forename: Assiamira
authors.initials: A
authors.lastname: Ferrara
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Holt
authors.forename: Noel S
authors.initials: NS
authors.lastname: Weiss
mesh_terms: D000328:Adult; D000728:Androgens / Q000009:adverse effects*; D015992:Body Mass Index; D002140:California; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D016208:Databases, Factual; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000209:etiology; D004997:Ethinyl Estradiol / Q000009:adverse effects; D005006:Ethnicity; D005260:Female; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D044469:Racial Groups; D012307:Risk Factors
chemical_list: D000728:Androgens; D003278:Contraceptives, Oral, Hormonal; D004997:Ethinyl Estradiol