17-Hydroxyprogesterone Caproate and the Prevention of Preeclampsia [14G

Abstract

INTRODUCTION: Preeclampsia is a hypertensive disease caused by a dysfunction of the maternal and placental vasculature. Prior studies have shown that progesterone decreases inflammatory markers, mean arterial pressure and promotes vasodilation. Preeclampsia and preterm labor exhibit similar characteristics such as increased cytokines and inflammation. The goal of our study was to examine the association of 17-hydroxyprogesterone caproate and the development of preeclampsia. METHODS: We conducted a retrospective cohort study at a single high-risk obstetric center. All singleton pregnancies from January 1, 2016 through February 28, 2017 were identified. Patients with in multifetal gestations were excluded. Data were analyzed using Student t-test, chi-square test and logistic regression with significance set at P<.05. RESULTS: Our study included 1942 women, of which 96 women used 17-hydroxyprogesterone caproate. There was a significant difference in gravity (P<.001), parity (P .019) and gestational age at delivery (P<.001). There was no difference in the incidence of all forms of preeclampsia in patients exposed to 17-OH-P vs not exposed, P .640. No difference was found between preterm delivery secondary to preeclampsia with features and exposure to 17-OH-P, P .176. CONCLUSION: In our cohort, 17-hydroxyprogesterone caproate was not associated with a decrease in the incidence of preeclampsia or preterm delivery secondary to preeclampsia with features. Further studies are needed to determine if progesterone is a viable option for the prevention of preeclampsia.