Salivary Progesterone and Estriol Among Pregnant Women Treated with 17-alpha-hydroxyprogesterone Caproate or Placebo

Overview

Journal Am J Obstet Gynecol

Publisher Elsevier

Specialty Gynecology & Obstetrics

Date 2008 May 6

PMID 18456237

Citations 12

Authors

Mark A Klebanoff

Paul J Meis

Mitchell P Dombrowski

Yuan Zhao

Atef H Moawad

Allison Northen

Baha M Sibai

Jay D Iams

Michael W Varner

Steve N Caritis

Mary J OSullivan

Kenneth J Leveno

Menachem Miodovnik

Deborah Conway

Ronald J Wapner

Marshall Carpenter

Brian M Mercer

Susan M Ramin

John M Thorp

Alan M Peaceman

Affiliations

Soon will be listed here.

Abstract

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.

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.

Citing Articles

Preference of saliva over other body fluids as samples for clinical and laboratory investigations among healthcare workers in Ibadan, Nigeria.

Lasisi T, Lawal F Pan Afr Med J. 2020; 34:191.

PMID: 32180865 PMC: 7060920. DOI: 10.11604/pamj.2019.34.191.18738.

Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.

Dodd J, Grivell R, OBrien C, Dowswell T, Deussen A Cochrane Database Syst Rev. 2019; 2019(11).

PMID: 31745984 PMC: 6864412. DOI: 10.1002/14651858.CD012024.pub3.

Progestin therapy to prevent preterm birth: History and effectiveness of current strategies and development of novel approaches.

Mesiano S, Peters G, Amini P, Wilson R, Tochtrop G, van den Akker F Placenta. 2019; 79:46-52.

PMID: 30745115 PMC: 6766339. DOI: 10.1016/j.placenta.2019.01.018.

Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.

Dodd J, Grivell R, OBrien C, Dowswell T, Deussen A Cochrane Database Syst Rev. 2017; 10:CD012024.

PMID: 29086920 PMC: 6485912. DOI: 10.1002/14651858.CD012024.pub2.

Dispatches from the interface of salivary bioscience and neonatal research.

Voegtline K, Granger D Front Endocrinol (Lausanne). 2014; 5:25.

PMID: 24624119 PMC: 3940893. DOI: 10.3389/fendo.2014.00025.

References

Heine R, McGregor J, Goodwin T, Artal R, Hayashi R, Robertson P . Serial salivary estriol to detect an increased risk of preterm birth. Obstet Gynecol. 2000; 96(4):490-7. DOI: 10.1016/s0029-7844(00)01004-8. View

Tulchinsky D, SIMMER H . Sources of plasma 17alpha-hydroxyprogesterone in human pregnancy. J Clin Endocrinol Metab. 1972; 35(6):799-808. DOI: 10.1210/jcem-35-6-799. View

Hobel C . Stress and preterm birth. Clin Obstet Gynecol. 2004; 47(4):856-80. DOI: 10.1097/01.grf.0000142512.38733.8c. View

Darne J, McGarrigle H, Lachelin G . Increased saliva oestriol to progesterone ratio before preterm delivery: a possible predictor for preterm labor?. Br Med J (Clin Res Ed). 1987; 294(6567):270-2. PMC: 1245292. DOI: 10.1136/bmj.294.6567.270. View

Block B, Liggins G, Creasy R . Preterm delivery is not predicted by serial plasma estradiol or progesterone concentration measurements. Am J Obstet Gynecol. 1984; 150(6):716-22. DOI: 10.1016/0002-9378(84)90674-4. View

Reijnders F, Thomas C, Doesburg W, Rolland R, Eskes T . Endocrine effects of 17 alpha-hydroxyprogesterone caproate during early pregnancy: a double-blind clinical trial. Br J Obstet Gynaecol. 1988; 95(5):462-8. DOI: 10.1111/j.1471-0528.1988.tb12797.x. View

Brown A, Leite R, Strauss 3rd J . Mechanisms underlying "functional" progesterone withdrawal at parturition. Ann N Y Acad Sci. 2005; 1034:36-49. DOI: 10.1196/annals.1335.004. View

Johnson J, Lee P, Zachary A, Calhoun S, Migeon C . High-risk prematurity--progestin treatment and steroid studies. Obstet Gynecol. 1979; 54(4):412-8. View

Albrecht E, Pepe G . Source and regulation of 17 alpha-hydroxyprogesterone during baboon pregnancy. Biol Reprod. 1984; 31(3):471-9. DOI: 10.1095/biolreprod31.3.471. View

10.

Darne J, McGarrigle H, Lachelin G . Saliva oestriol, oestradiol, oestrone and progesterone levels in pregnancy: spontaneous labour at term is preceded by a rise in the saliva oestriol:progesterone ratio. Br J Obstet Gynaecol. 1987; 94(3):227-35. DOI: 10.1111/j.1471-0528.1987.tb02359.x. View

11.

Csapo A . Progesterone block. Am J Anat. 1956; 98(2):273-91. DOI: 10.1002/aja.1000980206. View

12.

Cousins L, Hobel C, Chang R, Okada D, Marshall J . Serum progesterone and estradiol-17beta levels in premature and term labor. Am J Obstet Gynecol. 1977; 127(6):612-5. DOI: 10.1016/0002-9378(77)90359-3. View

13.

Lockwood C . Testing for risk of preterm delivery. Clin Lab Med. 2003; 23(2):345-60. DOI: 10.1016/s0272-2712(03)00029-5. View

14.

Meis P, Klebanoff M, Thom E, Dombrowski M, Sibai B, Moawad A . Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med. 2003; 348(24):2379-85. DOI: 10.1056/NEJMoa035140. View

15.

Meis P, Klebanoff M, Dombrowski M, Sibai B, Leindecker S, Moawad A . Does progesterone treatment influence risk factors for recurrent preterm delivery?. Obstet Gynecol. 2005; 106(3):557-61. DOI: 10.1097/01.AOG.0000174582.79364.a7. View

16.

Rouse D, Caritis S, Peaceman A, Sciscione A, Thom E, Spong C . A trial of 17 alpha-hydroxyprogesterone caproate to prevent prematurity in twins. N Engl J Med. 2007; 357(5):454-61. DOI: 10.1056/NEJMoa070641. View

17.

Goodwin T . A role for estriol in human labor, term and preterm. Am J Obstet Gynecol. 1999; 180(1 Pt 3):S208-13. DOI: 10.1016/s0002-9378(99)70702-7. View

18.

da Fonseca E, Bittar R, Carvalho M, Zugaib M . Prophylactic administration of progesterone by vaginal suppository to reduce the incidence of spontaneous preterm birth in women at increased risk: a randomized placebo-controlled double-blind study. Am J Obstet Gynecol. 2003; 188(2):419-24. DOI: 10.1067/mob.2003.41. View

19.

Navarro D, Cabrera J, Falcon O, Jimenez P, Ruiz A, Chirino R . Monoclonal antibody characterization of progesterone receptors, estrogen receptors and the stress-responsive protein of 27 kDa (SRP27) in human uterine leiomyoma. J Steroid Biochem. 1989; 34(1-6):491-8. DOI: 10.1016/0022-4731(89)90133-7. View

20.

Goldman S, Weiss A, Almalah I, Shalev E . Progesterone receptor expression in human decidua and fetal membranes before and after contractions: possible mechanism for functional progesterone withdrawal. Mol Hum Reprod. 2005; 11(4):269-77. DOI: 10.1093/molehr/gah161. View