Progesterone receptor polymorphisms and clinical response to 17-alpha-hydroxyprogesterone caproate - 03/08/11
, Yinglei Lai, PhD b, c, Paul J. Meis, MD b, e, Mitchell P. Dombrowski, MD b, f, Baha Sibai, MD b, g, Catherine Y. Spong, MD a, b, Dwight J. Rouse, MD b, h, Celeste P. Durnwald, MD b, i, Steve N. Caritis, MD b, j, Ronald J. Wapner, MD b, k, Brian M. Mercer, MD b, l, Susan M. Ramin, MD b, m
Reprints: Tracy A. Manuck, MD, 30 North 1900 East, Room 2B200, Salt Lake City, Utah 84132Résumé |
Objective |
Seventeen-alpha-hydroxyprogesterone caproate (17-OHPC) reduces recurrent preterm birth (PTB). We hypothesized that single nucleotide polymorphisms in the human progesterone receptor (PGR) affect response to 17-OHPC in the prevention of recurrent PTB.
Study Design |
We conducted secondary analysis of a study of 17-OHPC vs placebo for recurrent PTB prevention. Twenty PGR gene single nucleotide polymorphisms were studied. Multivariable logistic regression assessed for an interaction between PGR genotype and treatment status in modulating the risk of recurrent PTB.
Results |
A total of 380 women were included; 253 (66.6%) received 17-OHPC and 127 (33.4%) received placebo. In all, 61.1% of women were African American. Multivariable logistic regression demonstrated significant treatment-genotype interactions (either a beneficial or harmful treatment response) for African Americans delivering <37 weeks' gestation for rs471767 and rs578029, and for Hispanics/Caucasians delivering <37 weeks' gestation for rs500760 and <32 weeks' gestation for rs578029, rs503362, and rs666553.
Conclusion |
The clinical efficacy and safety of 17-OHPC for recurrent PTB prevention may be altered by PGR gene polymorphisms.
Le texte complet de cet article est disponible en PDF.Key words : genetic polymorphisms, progesterone receptor, recurrent preterm birth, 17-alpha hydroxyprogesterone caproate
Plan
| Cite this article as: Manuck TA, Lai Y, Meis PJ, et al. Progesterone receptor polymorphisms and clinical response to 17-alpha-hydroxyprogesterone caproate. Am J Obstet Gynecol 2011;205:135.e1-9. |
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| The project described was supported by the following grant numbers from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): HD27860, HD36801, HD27917, HD21414, HD27861, HD27869, HD27905, HD34208, HD34116, HD21410, HD27915, HD34136, HD34210, HD34122, HD40500, HD40544, HD34116, HD40560, and HD40512. This paper does not necessarily represent the official views of the NICHD or National Institutes of Health. |
Vol 205 - N° 2
P. 135.e1-135.e9 - août 2011 Retour au numéro
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