Carbohydrate intolerance in patients receiving oral tocolytics.

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Pharmacology

Background:

• Preterm labor management often involves tocolytic agents.
• Terbutaline is a commonly used beta-2 adrenergic agonist for tocolysis.
• The impact of oral terbutaline on maternal glucose metabolism requires thorough investigation.

Purpose of the Study:

• To prospectively evaluate the effects of oral terbutaline on glucose metabolism in patients with preterm labor.
• To determine the incidence of abnormal glucose tolerance tests and gestational diabetes in women receiving oral terbutaline.
• To compare glucose metabolism parameters between patients treated with oral terbutaline and a control group.

Main Methods:

• Prospective study involving 86 patients admitted for preterm labor (24-35 weeks' gestation).
• Patients received oral terbutaline (5 mg every 4-6 hours) after initial intravenous tocolysis.
• Glucose challenge tests and oral glucose tolerance tests were administered to assess glucose metabolism.

Main Results:

• A significantly higher proportion of the terbutaline group (63%) exhibited abnormal glucose challenge test results compared to the control group (26.7%) (p < 0.001).
• Mean fasting blood sugar and 1-hour postchallenge glucose levels were significantly elevated in the terbutaline group (p < 0.0001).
• The incidence of gestational diabetes was significantly higher in the terbutaline group (11.6%) versus the control group (2.3%) (p < 0.05).

Conclusions:

• Oral terbutaline therapy significantly affects glucose tolerance during pregnancy.
• Pregnant patients receiving oral terbutaline for preterm labor suppression should be screened for gestational diabetes.
• This finding highlights the importance of monitoring glucose metabolism in women undergoing oral terbutaline treatment.