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Efficacy and safety of hexaprenaline in pregnant women at risk of premature birth: the effect of polymorphism of the ADRB2 gene

DOI: https://doi.org/10.29296/25877305-2021-08-10
Issue: 
8
Year: 
2021

G. Proklova(1); Associate Professor R. Chilova(1), MD; Associate Professor E. Sokova(1, 2),
Candidate of Medical Sciences; R. Kazakov(2), Candidate of Biological Sciences; E. Zhukova(1), Candidate of
Medical Sciences; K. Akopov(3); O. Pobedinskaya(1), Candidate of Medical Sciences (1)I.M. Sechenov First
Moscow State Medical University (Sechenov University), Ministry of Health of Russia (2)Research Center for
Examination of Medical Products, Ministry of Health of Russia, Moscow (3)S.S. Yudin City Clinical Hospital,
Branch, Female Counseling Center Three, Moscow

Hexoprenaline has been shown to be an effective tocolytic drug in pregnant women at risk for premature birth (PB). The efficacy and safety of hexoprenaline are affected by the ADRB2 gene polymorphisms, including missense mutations associated with Gly16Arg and Gln27Glu substitutions, which can perform a protective function and affect predisposition to PB. Objective: to analyze the impact of the ADRB2 gene polymorphisms on the risk for PB as well as the efficiency and safety of tocolytic pharmacotherapy with hexoprenaline in pregnant women at risk for PB. Subjects and methods. The investigation involved 120 pregnant women. A study group included 60 patients at risk for PB who received tocolytic therapy with hexoprenaline. A control group consisted of women who had given birth to full-term children (at 37–41 weeks) and did not have a need for tocolytic therapy during pregnancy. The Gly16Arg and Gln27Glu polymorphism in the ADRB2 gene was determined in all the study participants, by using polymerase chain reaction-restriction fragment length polymorphism. The findings were compared with the indicators of the efficacy and safety of hexoprenaline. Results. The pregnant women at risk for PB were shown to have the 16Arg allele significantly less commonly (p=0.028) and the 16Gly/Gly genotype in the ADRB2 gene significantly more commonly (p=0.027). The efficacy of hexoprenaline was lower in the carriers of the genotypes indicating the high or low expression of β2-adrenoreceptors. 53% of pregnant women had adverse hexoprenaline reactions: tachycardia (47%) and headache (6%). Their incidence was unassociated with the ADRB2 gene polymorphism.

Keywords: 
obstetrics and gynecology
hexoprenaline
genotyping
tocolytic therapy
preterm birth
single nucleotide polymorphisms
ADRB2



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