The Rates of Abnormal Glucose Challenge Tests and Gestational Diabetes in Women Receiving 17α-Hydroxyprogesterone Caproate

 

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ABSTRACT

We compared the rates of abnormal 1-hour glucose challenge tests (GCT) and gestational diabetes (GDM) between women receiving 17α-hydroxyprogesterone caproate (17-P) and women who did not receive 17-P to determine if the effect varies based on the number of doses received or in a group of high-risk obese women. We performed a secondary analysis of a prospective cohort study where women with a history of a previous preterm delivery in the antecedent pregnancy followed at a high-risk clinic were offered 17-P. GCT was performed after the initiation of 17-P, and doses given prior to testing were recorded. Rates of abnormal GCT and GDM were compared between those receiving 17-P (n = 67) and controls (n = 140). Mean glucose values (112.4 versus 111.3, p = 0.8), rate of abnormal GCT (23.9% versus 20%, adjusted odds ratio 1.45, 95% confidence interval 0.7 to 3.0), and rate of GDM (6% versus 8.6%, adjusted odds ratio 1.21, 95% confidence interval 0.3 to 4.5) were similar between groups. In this prospective study, 17-P administration to women at risk of recurrent preterm delivery did not significantly affect glucose tolerance.

REFERENCES

• 1 Meis P J, Klebanoff M, Thom E National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network et al. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate.  N Engl J Med. 2003;  348 2379-2385
  CrossrefPubMedGoogle Scholar
• 2 Rode L, Langhoff-Roos J, Andersson C et al.. Systematic review of progesterone for the prevention of preterm birth in singleton pregnancies.  Acta Obstet Gynecol Scand. 2009;  88 1180-1189
  CrossrefPubMedGoogle Scholar
• 3 Dodd J M, Flenady V J, Cincotta R, Crowther C A. Progesterone for the prevention of preterm birth: a systematic review.  Obstet Gynecol. 2008;  112 127-134
  CrossrefPubMedGoogle Scholar
• 4 Dodd J M, Flenady V, Cincotta R, Crowther C A. Prenatal administration of progesterone for preventing preterm birth.  Cochrane Database Syst Rev. 2006;  (1) CD004947
  PubMedGoogle Scholar
• 5 Mackenzie R, Walker M, Armson A, Hannah M E. Progesterone for the prevention of preterm birth among women at increased risk: a systematic review and meta-analysis of randomized controlled trials.  Am J Obstet Gynecol. 2006;  194 1234-1242
  CrossrefPubMedGoogle Scholar
• 6 Society for Maternal Fetal Medicine Publications Committee . ACOG Committee Opinion number 419 October 2008 (replaces no. 291, November 2003). Use of progesterone to reduce preterm birth.  Obstet Gynecol. 2008;  112 963-965
  CrossrefPubMedGoogle Scholar
• 7 Picard F, Wanatabe M, Schoonjans K, Lydon J, O'Malley B W, Auwerx J. Progesterone receptor knockout mice have an improved glucose homeostasis secondary to β -cell proliferation.  Proc Natl Acad Sci U S A. 2002;  99 15644-15648
  CrossrefPubMedGoogle Scholar
• 8 Rebarber A, Istwan N B, Russo-Stieglitz K et al.. Increased incidence of gestational diabetes in women receiving prophylactic 17alpha-hydroxyprogesterone caproate for prevention of recurrent preterm delivery.  Diabetes Care. 2007;  30 2277-2280
  CrossrefPubMedGoogle Scholar
• 9 Waters T P, Schultz B A, Mercer B M, Catalano P M. Effect of 17alpha-hydroxyprogesterone caproate on glucose intolerance in pregnancy.  Obstet Gynecol. 2009;  114 45-49
  PubMedGoogle Scholar
• 10 Gyamfi C, Horton A L, Momirova V Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network et al. The effect of 17-alpha hydroxyprogesterone caproate on the risk of gestational diabetes in singleton or twin pregnancies.  Am J Obstet Gynecol. 2009;  201 392,e1-e5
  PubMedGoogle Scholar
• 11 Cheng Y W, Block-Kurbisch I, Caughey A B. Carpenter-Coustan criteria compared with the national diabetes data group thresholds for gestational diabetes mellitus.  Obstet Gynecol. 2009;  114 (2 Pt 1) 326-332
  CrossrefPubMedGoogle Scholar
• 12 Landon M B, Spong C Y, Thom E Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network et al. A multicenter, randomized trial of treatment for mild gestational diabetes.  N Engl J Med. 2009;  361 1339-1348
  CrossrefPubMedGoogle Scholar
• 13 Carpenter M W, Coustan D R. Criteria for screening tests for gestational diabetes.  Am J Obstet Gynecol. 1982;  144 768-773
  CrossrefPubMedGoogle Scholar
• 14 American College of Obstetricians and Gynecologists . ACOG Committee practice bulletin number 30: gestational diabetes.  Obstet Gynecol. 2001;  93 525-538
  PubMedGoogle Scholar

Baha SibaiM.D. 

Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Medical Sciences Building

Room 5464, 231 Albert Sabin Way, Cincinnati, OH 45267-0526

Email: baha.sibai@uc.edu