Increased incidence of gestational diabetes in women receiving prophylactic 17alpha-hydroxyprogesterone caproate for prevention of recurrent preterm delivery.
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 17alpha-hydroxyprogesterone caproate (17P) prophylaxis for the prevention of recurrent preterm birth.


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.
Rebarber
Andrei
A
Mount Sinai School of Medicine, Division of Maternal Fetal Medicine, New York, New York, USA. arebarber@mfmnyc.com
Istwan
Niki B
NB
Russo-Stieglitz
Karen
K
Cleary-Goldman
Jane
J
Rhea
Debbie J
DJ
Stanziano
Gary J
GJ
Saltzman
Daniel H
DH
D019326:17-alpha-Hydroxyprogesterone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D002208:Caproates; D016640:Diabetes, Gestational / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007273:Injections, Intramuscular; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*; D012008:Recurrence; D015149:Tocolytic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D002208:Caproates; D015149:Tocolytic Agents; D019326:17-alpha-Hydroxyprogesterone