The results of this study suggest that the use of certain types of hormonal contraceptives during the 5 years leading up to a pregnancy may be associated with the risk of developing gestational diabetes. Dr. Monique M. Hedderson from the Kaiser Permanente Medical Care Program of California, stated that, "The risk associated with gestational diabetes varied depending on the type of progestin in the hormonal contraceptive."
"We found evidence suggesting that use of hormonal contraceptives with a highly androgenic progestin was associated with a 43% increased risk of gestational diabetes," Dr. Hedderson said. On the other hand, she added, "use of hormonal contraceptives with a low androgenic progestin was associated with a 16% decreased risk of gestational diabetes."
The findings are based on 356 women with gestational diabetes and 368 women without the condition selected from a multiethnic cohort of 14,235 women who delivered a single live infant between January 1996 and June 1998.
The women were screened for gestational diabetes at 24 to 28 weeks of pregnancy and were members of Kaiser Permanente for at least 5 years before pregnancy. Information on contraceptive use in the 5 years before pregnancy was obtained from medical records and pharmacy data.
"Our data support an association between hyperandrogenicity and insulin resistance," Dr. Hedderson and her associates maintain.
The findings, which "need to be confirmed by other studies," the investigator said, support other studies suggesting that hormonal contraceptives, particularly the more androgenic formulations, can alter glucose tolerance.
Diabetes Care 2007;30:1062-1068.
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