Early Initiation of 17OHPC Does Not Increase Risk for Gestational Diabetes in Women With Prior Preterm Birth [13L

Abstract

INTRODUCTION: 17alpha-hydroxy progesterone caproate (17OHPC) is a common intervention to prevent recurrent preterm birth (PTB). The literature is inconsistent regarding an increased risk of gestational diabetes (GDM) in women on 17OHPC. Our objective was to determine the association of gestational age at initiation of 17OHPC and risk of GDM in women with spontaneous prior PTB (sPTB). METHODS: A retrospective study of singleton gestations with prior sPTB, who received weekly 17OHPC injections at two large Medicaid clinics from 2/2014- 6/2016. We excluded pre-gestational diabetes, multiple gestations, and women unable to complete glucose screening by 28 weeks. The study cohort was divided into group 1 (early initiation of 17OHPC at 16-20weeks) and group 2 (late initiation of 17OHPC at 21-26weeks). Primary outcome was the rate of GDM. Secondary outcomes included the rate of normal glucose screening and glucose intolerance. P-value of < .05 was considered statistically significant. RESULTS: 94 women met inclusion criteria. Demographics were similar in both groups, except mean BMI was higher in group 1 compared to group 2 (P=.002). Mean gestational weight gain (GWG) and the rate of excessive GWG were similar in both groups. The total number of doses of 17OHPC was higher in group 1 compared to group 2 (P < .0001). The rate of GDM was similar in both groups, even after adjusting for BMI and race. Secondary outcomes were also similar in both groups. CONCLUSION: Initiation of 17OHPC at 16-20 weeks does not increase the risk of gestational diabetes. Further studies with a large sample size, are suggested to confirm this observation.