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Rates of Recurrent Preterm Birth by Maternal Body Habitus in Women Receiving 17α-hydroxyprogesterone caproate.
MedLine Citation:
PMID:  23311766     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: To examine the influence of maternal pre-pregnancy body mass index (BMI) on the rates of recurrent spontaneous preterm birth (SPTB) in women receiving 17α-hydroxyprogesterone caproate (17P). Methods: Retrospective analysis of a cohort of 6,253 women with a singleton gestation and prior SPTB enrolled in 17P home administration program between 16.0-26.9 weeks. Data were grouped by pre-pregnancy BMI (lean <18.5kg/m(2), normal 18.5-24.9kg/m(2), overweight 25-29.9kg/m(2), and obese ≥30.0kg/m(2)). Delivery outcomes were compared using χ(2) and Kruskal-Wallis tests with statistical significance set at p<0.05. Results: SPTB<28 weeks was significantly lower in normal weight women. Rates of recurrent SPTB<37 weeks were highest in the group with BMI<18.5 kg/m(2). Lean gravidas were younger, more likely to smoke, and less likely to be African-American than those with normal or increased BMI. In logistic regression, after controlling for race and prior preterm birth <28 weeks, the risk of SPTB<37 weeks decreased 2% for every additional 1kg/m(2) increase in BMI. Conclusions: Recurrent spontaneous preterm delivery<37 weeks in patients on 17P is more common in lean women (BMI<18.5 kg/m(2)), and less common in obese women (BMI ≥30 kg/m(2)) suggesting that the current recommended dosing of 17P is adequate for women with higher BMI.
Authors:
Julia Timofeev; Maisa Feghali; Boyle Annelee; Niki Istwan; Rhea Debbie; Rita W Driggers
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-13
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
MedStar Health Washington Hospital Center, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Washington, DC.
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