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Effectiveness of Progesterone in Reducing Preterm Births May Be Altered By Genetic Predisposition SAN DIEGO -- January 30, 2009 -- Taking 17 alpha-hydroxyprogesterone caproate (17P) to prevent preterm birth is only effective for women with a genetic variation in the human progesterone receptor, according to a study reported at the 29th Annual Society for Maternal-Fetal Medicine (SMFM). "This study helps strengthen the theory that genetic variation in the human progesterone receptor plays an important role in the effectiveness of 17P," said study author Tracy Manuck, MD, University of Utah Hospitals & Clinics, Salt Lake City, Utah. The research assessed whether women with single nucleotide polymorphisms (SNPs) in the human progesterone receptor gene were more or less likely to respond to 17P for the prevention of recurrent spontaneous preterm birth. All patients (n = 389) in the study had at least 1 prior spontaneous preterm birth. Researchers extracted DNA from the saliva and then genotyped 20 SNPs in the region of the progesterone receptor gene. Of the patients 258 (66%) received 17P and 131 (34%) received a placebo. Spontaneous preterm birth was less common among women who received 17P. However, after controlling for factors known to be associated with recurrent prematurity, including smoking, number of prior preterm deliveries, and prepregnancy body mass index, 2 SNPs were identified among African American patients to be predictive of response to progesterone treatment. There was also an interaction between progesterone treatment and genotype of 3 additional polymorphisms for non-African American women delivering very preterm (<32 weeks gestation). "Dr. Manuck's research gives us a tantalising clue as to why 17P works for some women, but not for others," said Alan R. Fleischman, MD, March of Dimes, White Plains, New York. "With further research along these lines, we hope to someday be able to prevent preterm birth from happening in the first place by screening women before they get pregnant, and identifying those whose babies could get a healthy start in life with the help of 17P." SOURCE: March of Dimes Foundation E-mail this page to a friend or colleague! To print, use this version