Salivary progesterone and estriol among pregnant women treated with 17-⍺-hydroxyprogesterone caproate or placebo - 21/08/11

Doi : 10.1016/j.ajog.2008.03.003

Mark A. Klebanoff, MD, MPH ^a, Paul J. Meis, MD ^c, Mitchell P. Dombrowski, MD ^d, Yuan Zhao, MS ^b, Atef H. Moawad, MD ^e, Allison Northen, RN ^f, Baha M. Sibai, MD ^g, Jay D. Iams, MD ^h, Michael W. Varner, MD ⁱ, Steve N. Caritis, MD ^j, Mary J. O'Sullivan, MD ^k, Kenneth J. Leveno, MD ^l, Menachem Miodovnik, MD ^m, Deborah Conway, MD ⁿ, Ronald J. Wapner, MD ^o, Marshall Carpenter, MD ^p, Brian M. Mercer, MD ^q, Susan M. Ramin, MD ^r, John M. Thorp, MD ^s, Alan M. Peaceman, MD ^t
National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
^a National Institute of Child Health and Human Development, Bethesda, MD
^b George Washington University Biostatistics Center, Washington, DC
^c Departments of Obstetrics and Gynecology, Wake Forest University, Winston-Salem, NC
^d Wayne State University, Detroit, MI
^e University of Chicago, Chicago, IL
^f University of Alabama at Birmingham, Birmingham, AL
^g University of Cincinnati, Cincinnati, OH, and University of Tennessee, Memphis, TN
^h Ohio State University, Columbus, OH
ⁱ University of Utah, Salt Lake City, UT
^j University of Pittsburgh, Pittsburgh, PA
^k University of Miami, Miami, FL
^l University of Texas Southwestern Medical Center, Dallas, TX
^m Columbia University, New York, NY, and Washington Hospital Center, Washington, DC
ⁿ University of Texas at San Antonio, San Antonio, TX
^o Drexel University, Philadelphia, PA, and Columbia University, New York, NY
^p Brown University, Providence, RI
^q Case Western Reserve University, Cleveland, OH
^r University of Texas at Houston, Houston, TX
^s University of North Carolina, Chapel Hill, NC
^t Northwestern University, Chicago, IL

Résumé

Objective

The objectives of the study was to determine whether salivary progesterone (P) or estriol (E3) concentration at 16-20 weeks' gestation predicts preterm birth or the response to 17⍺-hydroxyprogesterone caproate (17OHPC) and whether 17OHPC treatment affected the trajectory of salivary P and E3 as pregnancy progressed.

Study Design

This was a secondary analysis of a clinical trial of 17OHPC to prevent preterm birth. Baseline saliva was assayed for P and E3. Weekly salivary samples were obtained from 40 women who received 17OHPC and 40 who received placebo in a multicenter randomized trial of 17OHPC to prevent recurrent preterm delivery.

Results

Both low and high baseline saliva P and E3 were associated with a slightly increased risk of preterm birth. However, 17OHPC prevented preterm birth comparably, regardless of baseline salivary hormone concentrations. 17OHPC did not alter the trajectory of salivary P over pregnancy, but it significantly blunted the rise in salivary E3 as well as the rise in the E3/P ratio.

Conclusion

17OHPC flattened the trajectory of E3 in the second half of pregnancy, suggesting that the drug influences the fetoplacental unit.

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Key words : 17-alpha-hydroxyprogesterone caproate, longitudinal studies, preterm birth, salivary estriol, salivary progesterone

Plan

Materials and Methods

Results

Comment

	Cite this article as: Klebanoff MA, Meis PJ, Dombrowski MP, et al. Salivary progesterone and estriol among pregnant women treated with 17-⍺-hydroxyprogesterone caproate or placebo. Am J Obstet Gynecol 2008;199:506.e1-506.e7.
	Reprints not available from the authors.
	Supported by Grants HD27860, HD36801, HD27917, HD21414, HD27861, HD27869, HD27905, HD34208, HD34116, HD21410, HD27915, HD34136, HD34210, HD34122, HD40500, HD40544, HD34116, HD40560, and HD40512 from the National Institute of Child Health and Human Development.

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Vol 199 - N° 5

P. null - novembre 2008 Retour au numéro

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Salivary progesterone and estriol among pregnant women treated with 17-⍺-hydroxyprogesterone caproate or placebo - 21/08/11

Résumé

Objective

Study Design

Results

Conclusion

Plan

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