Salivary progesterone and estriol among pregnant women treated with 17-alpha-hydroxyprogesterone caproate or placebo.
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 17alpha-hydroxyprogesterone caproate (17OHPC) and whether 17OHPC treatment affected the trajectory of salivary P and E3 as pregnancy progressed.


METHODS
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.


CONCLUSIONS
17OHPC flattened the trajectory of E3 in the second half of pregnancy, suggesting that the drug influences the fetoplacental unit.
Klebanoff
Mark A
MA
National Institute of Child Health and Human Development, Bethesda, MD, USA.
Meis
Paul J
PJ
Dombrowski
Mitchell P
MP
Zhao
Yuan
Y
Moawad
Atef H
AH
Northen
Allison
A
Sibai
Baha M
BM
Iams
Jay D
JD
Varner
Michael W
MW
Caritis
Steve N
SN
O'Sullivan
Mary J
MJ
Leveno
Kenneth J
KJ
Miodovnik
Menachem
M
Conway
Deborah
D
Wapner
Ronald J
RJ
Carpenter
Marshall
M
Mercer
Brian M
BM
Ramin
Susan M
SM
Thorp
John M
JM
Peaceman
Alan M
AM
D000077713:17 alpha-Hydroxyprogesterone Caproate; D000328:Adult; D004964:Estriol / Q000032:analysis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006908:Hydroxyprogesterones / Q000494:pharmacology / Q000627:therapeutic use*; D008137:Longitudinal Studies; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D021041:Placental Circulation / Q000187:drug effects; D011247:Pregnancy; D011374:Progesterone / Q000032:analysis*; D012463:Saliva / Q000737:chemistry*
D006908:Hydroxyprogesterones; D000077713:17 alpha-Hydroxyprogesterone Caproate; D011374:Progesterone; D004964:Estriol