Salivary progesterone and estriol among pregnant women treated with 17-α-hydroxyprogesterone caproate or placebo

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. O'Sullivan, Kenneth J. Leveno, Menachem Miodovnik, Deborah Conway, Ronald J. Wapner, Marshall Carpenter, Brian M. Mercer, Susan M. Ramin, John M. Thorp, Alan M. Peaceman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


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 17α-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.

Original languageEnglish (US)
Pages (from-to)506.e1-506.e7
JournalAmerican journal of obstetrics and gynecology
Issue number5
StatePublished - Nov 2008


  • 17-alpha-hydroxyprogesterone caproate
  • longitudinal studies
  • preterm birth
  • salivary estriol
  • salivary progesterone

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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