Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation with cervical length and preterm delivery

Vilma L Johnsson; Nina G Pedersen; Katharina Worda; Elisabeth Krampl-Bettelheim; Lillian Skibsted; Stefan Hinterberger; Isolde Strobl; Maria E Bowman; Roger Smith; Ann Tabor; Line Rode

doi:10.1111/aogs.13464

Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation with cervical length and preterm delivery

Vilma L Johnsson, Nina G Pedersen, Katharina Worda, Elisabeth Krampl-Bettelheim, Lillian Skibsted, Stefan Hinterberger, Isolde Strobl, Maria E Bowman, Roger Smith, Ann Tabor, Line Rode

Institut for Klinisk Medicin

2 Citationer (Scopus)

Abstract

INTRODUCTION: The aim of this study was to examine the association between plasma hormone concentrations, cervical length, and preterm delivery in twin pregnancies, including the effect of progesterone treatment.

MATERIAL AND METHODS: This study included 191 women pregnant with twins from a randomized placebo-controlled trial. A baseline blood sample was collected at 18-24 weeks before treatment with vaginal progesterone (n = 95) or placebo pessaries (n = 96), and 167 (87.4%) women had a second sample collected after 4-8 weeks of treatment. At baseline, 155 (81.2%) women had their cervical length measured. Progesterone, estradiol, and unconjugated estriol concentration was measured, and the association between hormone concentrations, cervical length, and gestational age at delivery was examined. Hormone concentrations were compared in the placebo and progesterone group. Statistical analysis included Spearman's rho, Mann-Whitney U test, Cuzick's test for trends, and linear regression analyses.

RESULTS: A short cervical length was associated with preterm delivery. Cervical length and hormone concentrations were not associated (Spearman's rho; progesterone -.05, estradiol .04, estriol .08). Decreasing gestational age at delivery was associated with higher progesterone and estradiol concentrations at baseline (P trend; progesterone 0.04, estradiol 0.02) but not in the second sample or in the weekly change between samples. Progesterone treatment did not increase the progesterone concentration.

CONCLUSIONS: Plasma concentrations of progesterone, estradiol, and unconjugated estriol at 18-24 weeks are not associated with cervical length or preterm delivery in twin pregnancies. Vaginal progesterone treatment does not increase the circulating progesterone concentration in twin pregnancies. Cervical length, but not hormone concentration, is predictive of preterm delivery in twin gestations.

Originalsprog	Engelsk
Tidsskrift	Acta Obstetricia et Gynecologica Scandinavica
Vol/bind	98
Udgave nummer	1
Sider (fra-til)	86-94
Antal sider	9
ISSN	0001-6349
DOI	https://doi.org/10.1111/aogs.13464
Status	Udgivet - jan. 2019

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10.1111/aogs.13464

aogs.13464Forlagets udgivne version, 858 KB

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Johnsson, V. L., Pedersen, N. G., Worda, K., Krampl-Bettelheim, E., Skibsted, L., Hinterberger, S., Strobl, I., Bowman, M. E., Smith, R., Tabor, A., & Rode, L. (2019). Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation with cervical length and preterm delivery. Acta Obstetricia et Gynecologica Scandinavica, 98(1), 86-94. https://doi.org/10.1111/aogs.13464

Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies : Relation with cervical length and preterm delivery. / Johnsson, Vilma L; Pedersen, Nina G; Worda, Katharina et al.

I: Acta Obstetricia et Gynecologica Scandinavica, Bind 98, Nr. 1, 01.2019, s. 86-94.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Johnsson, VL, Pedersen, NG, Worda, K, Krampl-Bettelheim, E, Skibsted, L, Hinterberger, S, Strobl, I, Bowman, ME, Smith, R, Tabor, A & Rode, L 2019, 'Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation with cervical length and preterm delivery', Acta Obstetricia et Gynecologica Scandinavica, bind 98, nr. 1, s. 86-94. https://doi.org/10.1111/aogs.13464

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title = "Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation with cervical length and preterm delivery",

abstract = "INTRODUCTION: The aim of this study was to examine the association between plasma hormone concentrations, cervical length, and preterm delivery in twin pregnancies, including the effect of progesterone treatment.MATERIAL AND METHODS: This study included 191 women pregnant with twins from a randomized placebo-controlled trial. A baseline blood sample was collected at 18-24 weeks before treatment with vaginal progesterone (n = 95) or placebo pessaries (n = 96), and 167 (87.4%) women had a second sample collected after 4-8 weeks of treatment. At baseline, 155 (81.2%) women had their cervical length measured. Progesterone, estradiol, and unconjugated estriol concentration was measured, and the association between hormone concentrations, cervical length, and gestational age at delivery was examined. Hormone concentrations were compared in the placebo and progesterone group. Statistical analysis included Spearman's rho, Mann-Whitney U test, Cuzick's test for trends, and linear regression analyses.RESULTS: A short cervical length was associated with preterm delivery. Cervical length and hormone concentrations were not associated (Spearman's rho; progesterone -.05, estradiol .04, estriol .08). Decreasing gestational age at delivery was associated with higher progesterone and estradiol concentrations at baseline (P trend; progesterone 0.04, estradiol 0.02) but not in the second sample or in the weekly change between samples. Progesterone treatment did not increase the progesterone concentration.CONCLUSIONS: Plasma concentrations of progesterone, estradiol, and unconjugated estriol at 18-24 weeks are not associated with cervical length or preterm delivery in twin pregnancies. Vaginal progesterone treatment does not increase the circulating progesterone concentration in twin pregnancies. Cervical length, but not hormone concentration, is predictive of preterm delivery in twin gestations.",

author = "Johnsson, {Vilma L} and Pedersen, {Nina G} and Katharina Worda and Elisabeth Krampl-Bettelheim and Lillian Skibsted and Stefan Hinterberger and Isolde Strobl and Bowman, {Maria E} and Roger Smith and Ann Tabor and Line Rode",

year = "2019",

month = jan,

doi = "10.1111/aogs.13464",

language = "English",

volume = "98",

pages = "86--94",

journal = "Acta Obstetricia et Gynecologica Scandinavica",

issn = "0001-6349",

publisher = "JohnWiley & Sons Ltd",

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TY - JOUR

T1 - Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies

T2 - Relation with cervical length and preterm delivery

AU - Johnsson, Vilma L

AU - Pedersen, Nina G

AU - Worda, Katharina

AU - Krampl-Bettelheim, Elisabeth

AU - Skibsted, Lillian

AU - Hinterberger, Stefan

AU - Strobl, Isolde

AU - Bowman, Maria E

AU - Smith, Roger

AU - Tabor, Ann

AU - Rode, Line

PY - 2019/1

Y1 - 2019/1

N2 - INTRODUCTION: The aim of this study was to examine the association between plasma hormone concentrations, cervical length, and preterm delivery in twin pregnancies, including the effect of progesterone treatment.MATERIAL AND METHODS: This study included 191 women pregnant with twins from a randomized placebo-controlled trial. A baseline blood sample was collected at 18-24 weeks before treatment with vaginal progesterone (n = 95) or placebo pessaries (n = 96), and 167 (87.4%) women had a second sample collected after 4-8 weeks of treatment. At baseline, 155 (81.2%) women had their cervical length measured. Progesterone, estradiol, and unconjugated estriol concentration was measured, and the association between hormone concentrations, cervical length, and gestational age at delivery was examined. Hormone concentrations were compared in the placebo and progesterone group. Statistical analysis included Spearman's rho, Mann-Whitney U test, Cuzick's test for trends, and linear regression analyses.RESULTS: A short cervical length was associated with preterm delivery. Cervical length and hormone concentrations were not associated (Spearman's rho; progesterone -.05, estradiol .04, estriol .08). Decreasing gestational age at delivery was associated with higher progesterone and estradiol concentrations at baseline (P trend; progesterone 0.04, estradiol 0.02) but not in the second sample or in the weekly change between samples. Progesterone treatment did not increase the progesterone concentration.CONCLUSIONS: Plasma concentrations of progesterone, estradiol, and unconjugated estriol at 18-24 weeks are not associated with cervical length or preterm delivery in twin pregnancies. Vaginal progesterone treatment does not increase the circulating progesterone concentration in twin pregnancies. Cervical length, but not hormone concentration, is predictive of preterm delivery in twin gestations.

AB - INTRODUCTION: The aim of this study was to examine the association between plasma hormone concentrations, cervical length, and preterm delivery in twin pregnancies, including the effect of progesterone treatment.MATERIAL AND METHODS: This study included 191 women pregnant with twins from a randomized placebo-controlled trial. A baseline blood sample was collected at 18-24 weeks before treatment with vaginal progesterone (n = 95) or placebo pessaries (n = 96), and 167 (87.4%) women had a second sample collected after 4-8 weeks of treatment. At baseline, 155 (81.2%) women had their cervical length measured. Progesterone, estradiol, and unconjugated estriol concentration was measured, and the association between hormone concentrations, cervical length, and gestational age at delivery was examined. Hormone concentrations were compared in the placebo and progesterone group. Statistical analysis included Spearman's rho, Mann-Whitney U test, Cuzick's test for trends, and linear regression analyses.RESULTS: A short cervical length was associated with preterm delivery. Cervical length and hormone concentrations were not associated (Spearman's rho; progesterone -.05, estradiol .04, estriol .08). Decreasing gestational age at delivery was associated with higher progesterone and estradiol concentrations at baseline (P trend; progesterone 0.04, estradiol 0.02) but not in the second sample or in the weekly change between samples. Progesterone treatment did not increase the progesterone concentration.CONCLUSIONS: Plasma concentrations of progesterone, estradiol, and unconjugated estriol at 18-24 weeks are not associated with cervical length or preterm delivery in twin pregnancies. Vaginal progesterone treatment does not increase the circulating progesterone concentration in twin pregnancies. Cervical length, but not hormone concentration, is predictive of preterm delivery in twin gestations.

U2 - 10.1111/aogs.13464

DO - 10.1111/aogs.13464

M3 - Journal article

C2 - 30218572

SN - 0001-6349

VL - 98

SP - 86

EP - 94

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 1

ER -

Plasma progesterone, estradiol, and unconjugated estriol concentrations in twin pregnancies: Relation with cervical length and preterm delivery

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