Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 205, Issue 2, Pages -Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2011.03.048
Keywords
genetic polymorphisms; progesterone receptor; recurrent preterm birth; 17-alpha hydroxyprogesterone caproate
Categories
Funding
- NICHD NIH HHS [U10 HD034208-16, UG1 HD040512, UG1 HD034208, UG1 HD040544, HD40512, U10 HD027905, HD21414, UG1 HD027915, HD27860, UG1 HD040560, HD34136, HD27869, UG1 HD034116, HD27861, U10 HD040500, U01 HD036801, HD40544, U10 HD040512, U10 HD040560, U10 HD027915, HD40560, U10 HD034116, U10 HD034208-17, U10 HD034136, U10 HD040544, UG1 HD027869, HD36801, HD21410, U10 HD034122, HD34116, U10 HD027917, U10 HD027869, U10 HD027860, HD40500, U10 HD034208, HD34208, HD27915, UG1 HD040500, HD27917, U10 HD021410, U10 HD036801, HD34210] Funding Source: Medline
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OBJECTIVE: Seventeen-alpha-hydroxyprogesterone caproate (17-OHPC) reduces recurrent preterm birth (PTB). We hypothesized that single nucleotide polymorphisms in the human progesterone receptor (PGR) affect response to 17-OHPC in the prevention of recurrent PTB. STUDY DESIGN: We conducted secondary analysis of a study of 17-OHPC vs placebo for recurrent PTB prevention. Twenty PGR gene single nucleotide polymorphisms were studied. Multivariable logistic regression assessed for an interaction between PGR genotype and treatment status in modulating the risk of recurrent PTB. RESULTS: A total of 380 women were included; 253 (66.6%) received 17-OHPC and 127 (33.4%) received placebo. In all, 61.1% of women were African American. Multivariable logistic regression demonstrated significant treatment-genotype interactions (either a beneficial or harmful treatment response) for African Americans delivering <37 weeks' gestation for rs471767 and rs578029, and for Hispanics/Caucasians delivering <37 weeks' gestation for rs500760 and <32 weeks' gestation for rs578029, rs503362, and rs666553. CONCLUSION: The clinical efficacy and safety of 17-OHPC for recurrent PTB prevention may be altered by PGR gene polymorphisms.
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