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American Journal of Obstetrics and Gynecology

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Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation - 30/10/12

Doi : 10.1016/j.ajog.2012.08.001 
Steve N. Caritis, MD a, Hyagriv N. Simhan, MD a, Yuan Zhao, MS o, Dwight J. Rouse, MD b, Alan M. Peaceman, MD c, Anthony Sciscione, DO d, Catherine Y. Spong, MD p, Michael W. Varner, MD e, Fergal D. Malone, MD f, Jay D. Iams, MD g, Brian M. Mercer, MD h, John M. Thorp, MD i, Yoram Sorokin, MD j, Marshall Carpenter, MD k, Julie Lo, MD l, Susan M. Ramin, MD m, Margaret Harper, MD, MS n

Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

a Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 
b Department of Obstetrics and Gynecology of the University of Alabama at Birmingham School of Medicine, Birmingham, AL 
c Department of Obstetrics and Gynecology of the Feinberg School of Medicine, Northwestern University, Chicago, IL 
d Department of Obstetrics and Gynecology of the Drexel University College of Medicine, Philadelphia, PA 
e Department of Obstetrics and Gynecology of the University of Utah School of Medicine, Salt Lake City, UT 
f Department of Obstetrics and Gynecology of the College of Physicians and Surgeons, Columbia University, New York, NY 
g Department of Obstetrics and Gynecology of the Ohio State College of Medicine, Ohio State University, Cleveland, OH 
h Department of Obstetrics and Gynecology of the Case Western Reserve University School of Medicine–MetroHealth Medical Center, Cleveland, OH 
i Department of Obstetrics and Gynecology of the University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 
j Department of Obstetrics and Gynecology of the Wayne State University School of Medicine, Detroit, MI 
k Department of Obstetrics and Gynecology of the Alpert Medical School, Brown University, Providence, RI 
l Department of Obstetrics and Gynecology of the University of Texas Southwestern Medical Center, Dallas, TX 
m Department of Obstetrics and Gynecology of the University of Texas Health Science Center at Houston, Houston, TX 
n Department of Obstetrics and Gynecology of the Wake Forest University Health Sciences, Winston-Salem, NC 
o Department of Obstetrics and Gynecology of the George Washington University Biostatistics Center, Washington, DC 
p Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 

Résumé

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.

Le texte complet de cet article est disponible en PDF.

Key words : 17-hydroxyprogesterone caproate, pharmacodynamics, twin gestation


Plan


 The remaining members of the network are listed in the Acknowledgments.
 The project described was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (HD27869, HD21410, HD40512, HD34136, HD34208, HD40485, HD27915, HD40544, HD40560, HD27917, HD40500, HD34116, HD40545, HD27860, HD3680) and does not necessarily represent the official views of the NICHD or the National Institutes of Health.
 The authors report no conflict of interest.
 Reprints not available from the authors.
 Cite this article as: Caritis SN, Simhan HN, Zhao Y, et al. Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation. Am J Obstet Gynecol 2012;207:396.e1-8.


© 2012  Mosby, Inc. Tous droits réservés.
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Vol 207 - N° 5

P. 396.e1-396.e8 - novembre 2012 Retour au numéro
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