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Randomized Controlled Trial
. 2012 Nov;207(5):396.e1-8.
doi: 10.1016/j.ajog.2012.08.001. Epub 2012 Aug 6.

Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation

Steve N Caritis  1 , Hyagriv N Simhan, Yuan Zhao, Dwight J Rouse, Alan M Peaceman, Anthony Sciscione, Catherine Y Spong, Michael W Varner, Fergal D Malone, Jay D Iams, Brian M Mercer, John M Thorp Jr, Yoram Sorokin, Marshall Carpenter, Julie Lo, Susan M Ramin, Margaret Harper; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
Collaborators, Affiliations
Randomized Controlled Trial

Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation

Steve N Caritis et al. Am J Obstet Gynecol. 2012 Nov.

Abstract

Objective: We sought to evaluate in women with twin gestation the relationship between 17-hydroxyprogesterone caproate (17-OHPC) concentration and gestational age at delivery and select biomarkers of potential pathways of drug action.

Study design: Blood was obtained between 24-28 weeks (epoch 1) and 32-35 weeks (epoch 2) in 217 women with twin gestation receiving 17-OHPC or placebo. Gestational age at delivery and concentrations of 17-OHPC, 17-hydroxyprogesterone, progesterone, C-reactive protein (CRP), and corticotrophin-releasing hormone were assessed.

Results: Women with higher concentrations of 17-OHPC delivered at earlier gestational ages than women with lower concentrations (P < .001). Women receiving 17-OHPC demonstrated significantly higher (P = .005) concentrations of CRP in epoch 1 than women receiving placebo but CRP values were similar in epoch 2 in both groups. A highly significant (P < .0001) positive relationship was observed between 17-OHPC concentration and progesterone and 17-hydroxyprogesterone concentrations at both epochs. Corticotropin-releasing hormone concentrations did not differ by treatment group.

Conclusion: 17-OHPC may adversely impact gestational age at delivery in women with twin gestation.

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Conflict of interest statement

DISCLOSURE: None of the authors have a conflict of interest

Figures

Figure 1
Figure 1
Relationship of 17-OHPC concentration with progesterone and 17-hydroxyprogesterone in epoch 2. Spearman correlation coefficient = 0.46 (p<0.0001) for 17-OHPC vs progesterone and Spearman correlation coefficient = 0.29 (p=0.01) for 17-OHPC vs 17-hydroxyprogesterone.
Figure 2
Figure 2
Relationship of 17-OHPC to CRH concentration in epoch 2 and to the rate of change of CRH. Spearman correlation coefficient =0.31 (p=0.02) for 17-OHPC vs CRH concentration in epoch 2 and Spearman correlation coefficient = 0.34 (p=0.01) for 17-OHPC vs rate of change of CRH.
Figure 3
Figure 3
Scatterplot of 17-OHPC concentration and gestational age at delivery.
See this image and copyright information in PMC

Comment in

References

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