title: Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  17-OHPC may adversely impact gestational age at delivery in women with twin gestation.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Hyagriv N
authors.initials: HN
authors.lastname: Simhan
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Fergal D
authors.initials: FD
authors.lastname: Malone
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Marshall
authors.initials: M
authors.lastname: Carpenter
authors.forename: Julie
authors.initials: J
authors.lastname: Lo
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Margaret
authors.initials: M
authors.lastname: Harper
mesh_terms: D000077713:17 alpha-Hydroxyprogesterone Caproate; D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D006908:Hydroxyprogesterones / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D011247:Pregnancy; D059285:Pregnancy, Twin / Q000187:drug effects*; D047928:Premature Birth / Q000188:drug therapy* / Q000517:prevention & control; D011374:Progesterone / Q000097:blood; D011372:Progestins / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006908:Hydroxyprogesterones; D011372:Progestins; D000077713:17 alpha-Hydroxyprogesterone Caproate; D011374:Progesterone; D019326:17-alpha-Hydroxyprogesterone; D002097:C-Reactive Protein; D003346:Corticotropin-Releasing Hormone