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

Research paper by Steve N SN Caritis, Hyagriv N HN Simhan, Yuan Y Zhao, Dwight J DJ Rouse, Alan M AM Peaceman, Anthony A Sciscione, Catherine Y CY Spong, Michael W MW Varner, Fergal D FD Malone, Jay D JD Iams, Brian M BM Mercer, John M JM Thorp, Yoram Y Sorokin, Marshall M Carpenter, Julie J Lo, et al.

Indexed on: 11 Sep '12Published on: 11 Sep '12Published in: American Journal of Obstetrics & Gynecology



Abstract

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

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