655: Is the risk of gestational diabetes increased in women treated with 17-alpha-hydroxyprogesterone-caproate?

Abstract

To determine whether treatment with 17-alpha-hydroxyprogesterone-caproate (17-OHPc) is associated with an increased risk of gestational diabetes mellitus (GDM), and whether that risk is affected by obesity status. This is a single institution retrospective cohort study of women with a history of spontaneous preterm birth < 37 weeks. The study population included women with subsequent gestations between February 2009 and January 2019. The primary outcome was a diagnosis of GDM in women who received treatment with 17-OHPc injections, compared to those who did not. The secondary outcomes were the mean serum glucose (mg/dL) on 1 hour 50 gram glucose challenge test (GCT) and proportion of women with an abnormal GCT (≥ 130 mg/dL). Women were also stratified by body mass index greater than or equal to 30 kg/m2 for analysis. Among women receiving therapy with 17-OHPc, diagnosis of GDM was not significantly increased compared to those who were not treated (12.5% vs. 10.2%, p=0.267). Mean GCT values in treated versus untreated women were similar (113.7 vs. 116.1 mg/dL, p=0.338). Among 73 women who received adequate treatment (80% or more of prescribed doses of 17-OHPc), mean GCT value was higher compared to untreated women (123.1 mg/dL vs. 113.7 mg/dL, p=0.026). There was no difference in GCT scores when stratified by body mass index, but non-obese women had increased GCT scores if treated adequately with 17-OHPc (120.8 vs. 106.9, p=0.012). The proportion of women with GCT values ≥130 mg/dL was increased in women treated adequately with 17-OHPc (37.0% vs. 26.3%), but did not reach statistical significance (p= 0.062). With adjustment for race, age, body mass index and history of GDM in a prior pregnancy, adequate treatment with 17-OHPc predicted mean GCT value, but not diagnosis of GDM. Women who receive adequate treatment with 17-OHPc for prevention of preterm birth have higher GCT scores, but the diagnosis of GDM is not significantly increased.View Large Image Figure ViewerDownload Hi-res image Download (PPT)