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Relationship between 17-Hydroxyprogesterone Caproate Concentrations and Gestational Age at Delivery in Twin Gestation


Caritis, Steve N.; Simhan, Hyagriv N.; Zhao, Yuan; Rouse, Dwight J.; Peaceman, Alan M.; Sciscione, Anthony C.; Spong, Catherine Y.; Varner, Michael W.; Malone, Fergal D.; & Iams, Jay D., et al. (2012). Relationship between 17-Hydroxyprogesterone Caproate Concentrations and Gestational Age at Delivery in Twin Gestation. American Journal of Obstetrics & Gynecology, 207(5), 396.e1-8. PMCID: PMC3484214


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.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Obstetrics & Gynecology


Caritis, Steve N.
Simhan, Hyagriv N.
Zhao, Yuan
Rouse, Dwight J.
Peaceman, Alan M.
Sciscione, Anthony C.
Spong, Catherine Y.
Varner, Michael W.
Malone, Fergal D.
Iams, Jay D.
Mercer, Brian M.
Thorp, John M., Jr.
Sorokin, Yoram
Carpenter, Marshall W.
Lo, Julie
Ramin, Susan M.
Harper, Margaret A., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network