Drug for prevention of preterm birth may increase cancer risk in offsprings

A new study reveals the potential link between in utero exposure of 17-OHPC and cancer in offspring. Therefore caution is advised when using it during early pregnancy.

17-hydroxyprogesterone caproate (17-OHPC) is a synthetic progestogen that was first approved to treat gynecological and obstetrical conditions in the 1950s. Despite repeated concerns about the safety and short-term efficacy of 17-OHPC for the prevention of preterm birth in pregnant women, little is known about the long-term effects of 17-OHPC on offspring health.

A group of researchers led by Caitlin C.Murphy conducted this research with the objective to investigate the relationship between 17-OHPC exposure in utero and the risk of cancer in offspring. The findings were published in the American Journal of Obstetrics and Gynecology on 9th November, 2021.

The Child Health and Development Studies are a population-based cohort of over 18,000 mother-child dyads who received prenatal care through the Kaiser Foundation Health Plan in Oakland, California, between 1959 and 1966. Clinical data were extracted from mothers' medical records beginning six months before pregnancy and continuing until delivery.

The number and timing of 17-OHPC injections during pregnancy were determined by the researchers. Cancers diagnosed in offspring were tracked through 2019 using a link to the California Cancer Registry. Cox proportional hazards models were used to calculate adjusted hazard ratios (aHR) and their 95% confidence intervals, with follow-up time extending from the date of birth to the date of cancer diagnosis, death, or last contact.

During the 730,817 person-years of follow-up, 1,008 offspring were diagnosed with cancer. Approximately 1.0 percent of offspring (n=234) were exposed to 17-OHPC in utero. Exposure during the first trimester was linked to an increased risk of any cancer, and the risk increased as the number of injections increased.

Exposure during the second or third trimester increased the risk of male offspring but not female offspring. Offspring exposed to 17-OHPC in the first trimester had a higher risk of colorectal, prostate, and pediatric brain cancer than offspring who were not exposed.

"Our findings suggest taking this drug during pregnancy can disrupt early development, which may increase risk of cancer decades later," Murphy wrote "With this drug, we are seeing the effects of a synthetic hormone. Things that happened to us in the womb, or exposures in utero, are important risk factors for developing cancer many decades after we're born."

Reference:

Murphy, C. C., Cirillo, P. M., Krigbaum, N. Y., & Cohn, B. A. (2021). In utero exposure to 17α-hydroxyprogesterone caproate and risk of cancer in offspring. In American Journal of Obstetrics and Gynecology. Elsevier BV. https://doi.org/10.1016/j.ajog.2021.10.035