Maternal glucose intolerance and the subcutaneous terbutaline pump

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Pharmacology

Background:

• Gestational diabetes mellitus (GDM) is a common complication of pregnancy.
• Terbutaline is frequently used to manage preterm labor.
• The effect of terbutaline administration routes on maternal glucose tolerance requires clarification.

Purpose of the Study:

• To investigate the impact of subcutaneous terbutaline pump use on maternal glucose tolerance.
• To compare the incidence of gestational diabetes in patients using terbutaline pumps versus oral terbutaline and controls.
• To assess the need for insulin therapy in relation to terbutaline administration.

Main Methods:

• A 1-hour glucose tolerance test was employed.
• Study groups included 37 patients using subcutaneous terbutaline pumps, 54 patients on oral terbutaline, and 634 control subjects.
• Chi-squared analysis was used to compare the frequency of GDM and insulin requirements.

Main Results:

• The incidence of GDM was comparable between the terbutaline pump group (5%) and controls (6%), with no statistically significant difference (p = 0.8).
• Patients on oral terbutaline showed a higher incidence of GDM (11%) compared to controls, though not statistically significant (p = 0.4).
• A significantly higher proportion of patients using terbutaline pumps (100%) and oral terbutaline (50%) required insulin compared to controls (8%) (p < 0.01 and p = 0.03, respectively).

Conclusions:

• Subcutaneous terbutaline pump administration does not elevate the risk of gestational diabetes.
• Terbutaline therapy, irrespective of the route (pump or oral), is associated with an increased requirement for insulin to manage glycemic control.
• These findings highlight the metabolic side effects of terbutaline during pregnancy.