GESTATIONAL DIABETES-MELLITUS IN WOMEN RECEIVING BETA-ADRENERGICS ANDCORTICOSTEROIDS FOR THREATENED PRETERM DELIVERY

Objective: To determine whether the incidence of gestational diabetes mellitus (GDM) is increased in patients receiving corticosteroids with or without beta-adrenergic agents for threatened preterm delivery. Me thods: We reviewed the laboratory records of 3396 patients undergoing screening (1-hour glucose) and diagnostic testing (3-hour glucose tole rance test [GTT]) for GDM over 2 years. Patients with antepartum admis sions during which they received corticosteroids with or without beta- adrenergic agents for threatened preterm delivery were compared with a control group during the same period. Differences between the study a nd control groups were analyzed using X-2, Student t test, or Fisher e xact test where appropriate. P < .05 was considered significant. Resul ts: Fifty patients in the study group were compared with 1985 control patients. The remaining 1361 patients failed to meet inclusion criteri a. The overall incidence of diagnosed GDM was significantly greater in the corticosteroid-beta-adrenergic agents study group, in which five (23.8%) of 21 patients screened had abnormal 3-hour GTT results, compa red with 79 (4.0%) of 1985 controls (P = .001). One-hour glucose scree ning test results were abnormal in 60% of the study group compared wit h 25% of the controls (P < .001). Conclusion: Patients treated with be ta-adrenergic agents and corticosteroids for threatened preterm delive ry are at a significantly increased risk for developing GDM. The high rate of abnormal results in response to the 1-hour glucose screen sugg ests that this test is of limited value in patients exposed to these m edications. (C) 1997 by The American College of Obstetricians and Gyne cologists.