Association Between Contraceptive Use and Gestational Diabetes: Missouri Pregnancy Risk Assessment Monitoring System, 2007–2008

Abstract

IntroductionThe efficacy and safety of contraceptives have been questioned for decades; however, whether a relationship exists between hormonal contraceptives and gestational diabetes (GDM) is undetermined. The aim of this study was to investigate whether maternal risk for GDM was influenced by type of contraceptive method used before pregnancy.MethodsData collected in 2007 and 2008 by the Missouri Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed to determine if type of contraception before pregnancy influenced maternal risk for GDM. We used a logistic regression model to determine the adjusted odds for GDM given exposure to hormonal forms of contraception.ResultsOf the 2,741 women who completed the 2007–2008 PRAMS survey, 8.3% were diagnosed with gestational diabetes, and 17.9% of the respondents had used hormonal contraceptive methods. Women who used hormonal methods of birth control had higher odds for gestational diabetes (adjusted odds ratio [AOR] = 1.43; 95% confidence interval [CI], 1.32–1.55) than did women who used no contraception. A protective effect was also observed for women who had used barrier methods of contraception (AOR = 0.79; 95% CI, 0.72–0.86).ConclusionFindings suggest there may be a relationship between type of contraceptive method and GDM. More research is needed to verify contraception as a potential risk factor for GDM.

Prevalence and Risk Factors Associated With Gestational Diabetes Mellitus Among Pregnant Women: A Cross-Sectional Study in Ghana

“…In this current study, we observed previous use of oral contraceptive as independent risk factor of gestational diabetes. This is in consistent with a study by Kramer et al ( 21 ), who reported the use of oral contraceptives is associated with gestational diabetes ( 21 ). The agreement between the current and previous study provides evidence that hormonal contraceptive methods may increase a woman’s risk for GDM since most oral contraceptives are made up of oestrogen and progesterone which in excess induces hypercortisolism and therefore leading to insulin resistance and hyperglycaemia in pregnancy.…”

Gonadal hormonal factors before menopause and incident type 2 diabetes in women: A 22‐year follow‐up of 83 799 women from the E3N cohort study

“…This means that women who were nonusers were more likely to have risk factors for diabetes than users, and this is logical as risk factors are limitations or contraindications for oral contraceptive treatment. A positive association between oral contraceptives and gestational diabetes mellitus has already been reported 10 …”

“…In many populations, the incidence of type 2 diabetes is higher in men than in women, and this may be explained by exposure to female gonadal hormones 8 . For women, the association between exposure to gonadal hormones and the risk of type 2 diabetes is widely discussed 9‐17 . The findings about the influence of the age of menopause on the risk of type 2 diabetes are controversial 14,15 .…”

“…A higher number of pregnancies seems to increase the risk of type 2 diabetes 12,13 . The use of oestroprogestative contraceptives is associated with a higher risk of type 2 diabetes in some studies but not in others 10,11 . Menopausal hormonal treatment was reported to be associated with a lower incidence of diabetes 16,17 .…”

Associations of periconceptional oral contraceptive use with pregnancy complications and adverse birth outcomes

“…Only Kramer et al . 14 reported that any past usage (no time limit) of hormonal contraceptives (including OCs, injections, patches, cervical rings and intrauterine devices) increased the risk of gestational diabetes compared with no contraception. Given our findings and the review of evidence that OC use may only minimally dysregulate glucose control, 43 an association between OC use and gestational diabetes seems unlikely for those discontinuing before conception.…”