7828 First Trimester Serum 11-Deoxycorticosterone Predicts Extreme Premature Childbirth

Abstract Disclosure: E.K. Ronde Salminen: None. S. Schoenmakers: None. B.D. van Zelst: None. S.A. van den Berg: None. Background: Preterm birth is the leading cause of perinatal mortality and morbidity worldwide. Unfortunately, the prediction of preterm birth remains challenging, causing unnecessary hospital admittance and overexposure to medication. Studies have shown that metabolites of progesterone can influence uterine contractility[1] and serum levels of 11-deoxycorticosterone have been shown to correlate with an increased risk of preterm birth before 32 weeks of gestation2. The aim of this prospective study was to determine whether first trimester measurement of the progesterone metabolites 11-deoxycorticosterone (11-DOC) and 16-alpha hydroxyprogesterone (16-OHP) could be used as a predictive marker for preterm birth. Methods and results: A cohort of 386 pregnant women were included at 12 weeks of gestation between 2014-2016. Their obstetric histories and comorbidities were noted and their plasma was frozen. Of these women, n=26 delivered prior to 32 weeks of gestation and n=286 delivered at term. 11-DOC and 16-OHP were determined using LC-MS/MS. Mann-Whitney U test was used to statistically analyze differences between the groups. There was a highly significant difference in the level of 11-DOC between women delivering prior to 32 weeks of gestation in comparison to women delivering after 37 weeks of gestation (p=0.007). 16-OHP levels tended to be different between the two groups, but this did not reach statistical significance (p=0.062). No difference was found in the ratio 16-alpha hydroxyprogesterone/11-deoxycorticosterone between the two groups (p=0.916). Conclusion: Plasma levels of progesterone metabolites collected late in the first trimester of pregnancy predicts preterm birth prior to 32 weeks of pregnancy. References: 1.Patil AS, Swamy GK, Murtha AP et al, Progesterone metabolites produced by cytochrome P450 3A modulate uterine contractility in a murine model, Reprod Sci, 2015 Dec 22(12):1577-1586 2.Patil AS, Gaikwad NW, Grotegut CA et al, Alterations in endogenous progesterone metabolism associated with spontaneous very preterm delivery, Hum Reprod Open, 2020 Apr 6;2020(2):hoaa007 Presentation: 6/1/2024