| Progesterone for prevention of recurrent preterm birth: impact of gestational age at previous delivery. | |
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MedLine Citation:
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PMID: 16157124 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Preterm birth occurs in 1 of 8 pregnancies and may result in significant morbidity and mortality. 17-alpha hydroxyprogesterone caproate (17-OHP caproate) has been found to be efficacious in reducing the risk of subsequent preterm delivery in women who have had a previous spontaneous preterm birth (sPTB). This analysis was undertaken to evaluate if 17-OHP caproate therapy works preferentially depending on the gestational age at previous spontaneous delivery. We hypothesized that treatment with 17-OHP caproate is more effective in prolonging pregnancy depending on the gestational age of the earliest previous preterm birth (20-27.9, 28-33.9 vs 34-36.9 weeks). STUDY DESIGN: This was a secondary analysis of 459 women with a previous sPTB enrolled in a randomized controlled trial evaluating 17-OHP caproate versus placebo. Effectiveness of 17-OHP caproate for pregnancy prolongation was evaluated based on gestational age at earliest previous delivery according to clinically relevant groupings (20-27.9, 28-33.9, and 34-36.9 weeks). Statistical analysis included the chi-square, Fisher exact, and Kruskal-Wallis tests, logistic regression, and survival analysis using proportional hazards. RESULTS: Gestational age at earliest previous delivery was similar between women treated with 17-OHP caproate or placebo (P = .1). Women with earliest delivery at 20 to 27.9 weeks and at 28 to 33.9 weeks delivered at significantly more advanced gestational age if treated with 17-OHP caproate than with placebo (median 37.3 vs 35.4 weeks, P = .046 and 38.0 vs 36.7 weeks, P = .004, respectively) and were less likely to deliver <37 weeks (42% vs 63%, P = .026 and 34% vs 56%, P = .005, respectively). Those with earliest delivery at 34 to 36.9 weeks were not significantly different between 17-OHP caproate or control. CONCLUSION: 17-OHP caproate therapy given to prevent recurrent PTB is associated with a prolongation of pregnancy overall, and especially for women with a previous spontaneous PTB at <34 weeks. |
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Authors:
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Catherine Y Spong; Paul J Meis; Elizabeth A Thom; Baha Sibai; Mitchell P Dombrowski; Atef H Moawad; John C Hauth; Jay D Iams; Michael W Varner; Steve N Caritis; Mary J O'Sullivan; Menachem Miodovnik; Kenneth J Leveno; Deborah Conway; Ronald J Wapner; Marshall Carpenter; Brian Mercer; Susan M Ramin; John M Thorp; Alan M Peaceman; Steven Gabbe; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 193 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2005-09-13 Completed Date: 2005-10-26 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1127-31 Citation Subset: AIM; IM |
Affiliation:
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National Institute of Child Health and Human Development, Bethesda, MD, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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17-alpha-Hydroxyprogesterone
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therapeutic use* Female Gestational Age* Humans Logistic Models Pregnancy Premature Birth / prevention & control* Proportional Hazards Models Recurrence |
| Grant Support | |
ID/Acronym/Agency:
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HD21410/HD/NICHD NIH HHS; HD21414/HD/NICHD NIH HHS; HD27860/HD/NICHD NIH HHS; HD27861/HD/NICHD NIH HHS; HD27869/HD/NICHD NIH HHS; HD27905/HD/NICHD NIH HHS; HD27915/HD/NICHD NIH HHS; HD27917/HD/NICHD NIH HHS; HD34116/HD/NICHD NIH HHS; HD34122/HD/NICHD NIH HHS; HD34136/HD/NICHD NIH HHS; HD34208/HD/NICHD NIH HHS; HD34210/HD/NICHD NIH HHS; HD36801/HD/NICHD NIH HHS; HD40500/HD/NICHD NIH HHS; HD40512/HD/NICHD NIH HHS; HD40544/HD/NICHD NIH HHS; HD40560/HD/NICHD NIH HHS; M01-RR-000080/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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68-96-2/17-alpha-Hydroxyprogesterone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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