5&amp;lt;i&amp;gt;β&amp;lt;/i&amp;gt;-Dihydroprogesterone and Human Preterm Labor

Penelope M Sheehan,Shaun P Brennecke,Gregory E Rice

doi:10.4236/ojemd.2014.45013

5&lt;i&gt;β&lt;/i&gt;-Dihydroprogesterone and Human Preterm Labor

Penelope M Sheehan, Shaun P Brennecke + Show 1 more

Open Access

https://doi.org/10.4236/ojemd.2014.45013

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Abstract

We previously investigated the progesterone metabolite 5β-dihydroprogesterone (5βDHP) in relation to human parturition at term, demonstrating that peripheral venous concentrations decrease in association with the onset of spontaneous labour. In this study our aim was to determine if 5βDHP concentrations were lower in women presenting in spontaneous preterm labour than in controls matched for gestational age. Blood samples were obtained from women presenting in spontaneous preterm labour (n = 20). The diagnosis was made on the presence of regular contractions and cervical effacement and dilatation of at least 3 cms. All women in the preterm labour group delivered before 37 weeks gestation. Blood samples were then obtained from controls, closely matched for gestational age with uncomplicated pregnancies. The preterm labour group was further stratified by cause into three groups, chorioamnionitis (n = 5), abruption (n = 4) and idiopathic (n = 11). Following organic solvent extraction, steroids were separated by HPLC and 5βDHP quantified by radioimmunoassay. Women in the idiopathic preterm labour group were found to have significantly lower circulating concentrations of 5βDHP than controls (p

Highlights

Spontaneous preterm birth accounts for up to 15% of the perinatal mortality in infants born without congenitalHow to cite this paper: Sheehan, P.M., et al (2014) 5β-Dihydroprogesterone and Human Preterm Labor
When compared with non-labouring controls matched for gestational age, patients in idiopathic preterm labour had significantly lower plasma 5βDHP concentrations (Table 3, Figure 1)
Analysis of the abruption group demonstrated no significant difference between patients and matched controls (Figure 3)

Summary

Introduction

Spontaneous preterm birth accounts for up to 15% of the perinatal mortality in infants born without congenitalHow to cite this paper: Sheehan, P.M., et al (2014) 5β-Dihydroprogesterone and Human Preterm Labor. In Victoria, Australia, the commonest cause of neonatal death in the absence of congenital abnormalities (birthweight of 400 g or greater) was spontaneous preterm delivery, accounting for 32.6% of neonatal deaths [1]. Recent studies have identified four common pathways leading to preterm labour and delivery; inflammation, decidualhaemorrhage, uterine over-distension and premature activation of the normal physiologic initiators of labour [2]. A number of predictive tests are currently used in an attempt to identify those women who will deliver preterm, including studies of uterine contractions, fibronectin, and ultrasound assessment of the cervix. The effectiveness of these tests is limited by our lack of knowledge of the normal processes of parturition

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