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    Could hormonal contraceptives increase risk of gestational diabetes?

     

    A recent Centers for Disease Control and Prevention (CDC) study of data from a single state suggests that there may be a connection between use of hormonal contraceptives prior to pregnancy and increased risk of developing gestational diabetes (GDM). The authors caution, however, that their findings suggest an underlying causal mechanism rather than establishing a causal relationship and are not generalizable to pregnant women with our outcomes or in other states.

    The analysis, using a logistic regression model to determine adjusted odds of GDM following exposure to hormonal contraceptives, reflects  data from 2741 women collected in 2007 and 2008 by the Missouri Pregnancy Risk Assessment Monitoring System (PRAMS). Missouri is one of 40 states and New York City that administer the ongoing, population-based survey, which is designed to identify and monitor select maternal experiences, attitudes, and behaviors that occur before, during, and shortly after pregnancy in women who deliver a live infant.

    Of the women who completed the Missouri PRAMS survey, 8.3% were given a GDM diagnosis in their most recent pregnancy. Hormonal methods were the contraceptives most commonly used by respondents (17.9%), followed by barrier methods (17.2%), fertility awareness/rhythm method (6.8%), and other (2.3%). Overall, 56% of women surveyed said they used no contraception.

    When compared with women who used no contraception, those who used hormonal contraceptives had higher odds of developing GDM (adjusted odds ratio [AOR] = 1.43; 95% confidence interval [CI], 1.32-1.55). However, a protective effect for GDM was noted for women using barrier methods of contraception (AOR = 0.79; 95% CI, 0.72 – 0.86) versus no contraception and for those whose pregnancy was unintended versus intended (AOR = 0.39; 95% CI, 0.37-0.42).

    Investigators concluded that there might be a relationship between the type of contraception used and GDM. Noting that this is the first study to evaluate the relationship between type of contraception used before pregnancy and risk of GME, they recommended further research into the possible correlation.



     

     

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    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.
    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is an editorial consultant for Contemporary OB/GYN.

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