The risk for preterm labor in women receiving 17 alpha-hydroxyprogesterone caproate prophylaxis for preterm birth prevention.

Abstract

We sought to identify maternal or clinical characteristics of women likely to develop preterm labor (PTL) at <34 weeks' gestation while receiving 17 alpha-hydroxyprogesterone caproate (17P) prophylaxis. Current singleton gestations with prior preterm delivery enrolled for outpatient 17P administration at <27 weeks' gestation were identified ( N = 1177). Maternal and clinical characteristics were compared between women hospitalized and diagnosed with PTL at <34 weeks' gestation (PTL group, N = 270) and those without PTL (No PTL group, N = 660). PTL at <34 weeks' gestation occurred in 270/1177 (22.9%) of patients receiving 17P prophylaxis (mean gestational age at diagnosis was 28.3 +/- 4.0 weeks). Recurrent preterm delivery occurred in 73.3% of women with PTL at <34 weeks. Maternal age, marital status, race, tobacco use, cerclage, gestational age at start of 17P, and Medicaid status were similar between the groups. Women developing PTL at <34 weeks were more likely to have >1 prior preterm delivery than those without PTL (35.2% versus 25.9%, P = 0.006, odds ratio [95% confidence interval] 1.5 [1.1, 2.1]). Women receiving 17P prophylaxis remain at increased risk for PTL and preterm birth. Patient education and surveillance for PTL symptoms may be warranted in women with a history of more than one prior preterm delivery.

• Authors: Saju Joy, Debbie J Rhea, Niki B Istwan, Cheryl N Desch, Gary Stanziano
• Journal: American journal of perinatology (Am J Perinatol) Vol. 27 Issue 4 Pg. 343-8 (Apr 2010) ISSN: 1098-8785 [Electronic] United States
• PMID: 20013580 (Publication Type: Comparative Study, Journal Article)
• Copyright: Thieme Medical Publishers.

Chemical References

• 17-alpha-Hydroxyprogesterone

Topics

• 17-alpha-Hydroxyprogesterone (administration & dosage)
• Adult
• Cohort Studies
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Fetal Monitoring (methods)
• Follow-Up Studies
• Gestational Age
• Humans
• Infant, Newborn
• Obstetric Labor, Premature (chemically induced, epidemiology, prevention & control)
• Pregnancy
• Pregnancy Outcome
• Pregnancy, High-Risk
• Premature Birth (prevention & control)
• Probability
• Recurrence
• Retrospective Studies
• Risk Assessment