17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30 mm.

Abstract

OBJECTIVE:

We sought to evaluate whether 17 alpha-hydroxyprogesterone caproate (17-OHP) reduces preterm birth (PTB) in nulliparous women with a midtrimester cervical length (CL) <30 mm.

STUDY DESIGN:

In this multicenter randomized controlled trial, nulliparous women with a singleton gestation between 16 and 22 3/7 weeks with an endovaginal CL <30 mm (<10th percentile in this population) were randomized to weekly intramuscular 17-OHP (250 mg) or placebo through 36 weeks. The primary outcome was PTB <37 weeks.

RESULTS:

The frequency of PTB did not differ between the 17-OHP (n = 327) and placebo (n = 330) groups (25.1% vs 24.2%; relative risk, 1.03; 95% confidence interval, 0.79-1.35). There also was no difference in the composite adverse neonatal outcome (7.0% vs 9.1%; relative risk, 0.77; 95% confidence interval, 0.46-1.30).

CONCLUSION:

Weekly 17-OHP does not reduce the frequency of PTB in nulliparous women with a midtrimester CL <30 mm.

• Authors: William A Grobman, Elizabeth A Thom, Catherine Y Spong, Jay D Iams, George R Saade, Brian M Mercer, Alan T N Tita, Dwight J Rouse, Yoram Sorokin, Ronald J Wapner, Kenneth J Leveno, Sean Blackwell, M Sean Esplin, Jorge E Tolosa, John M Thorp Jr, Steve N Caritis, J Peter Van Dorsten, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 207 Issue 5 Pg. 390.e1-8 (Nov 2012) ISSN: 1097-6868 [Electronic] United States
• PMID: 23010094 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2012 Mosby, Inc. All rights reserved.

Chemical References

• Hydroxyprogesterones
• Progestins
• 17 alpha-Hydroxyprogesterone Caproate

Topics

• 17 alpha-Hydroxyprogesterone Caproate
• Adolescent
• Adult
• Cervical Length Measurement (drug effects)
• Female
• Humans
• Hydroxyprogesterones (therapeutic use)
• Infant, Newborn
• Infant, Premature
• Parity (drug effects)
• Pregnancy
• Pregnancy Outcome
• Premature Birth (prevention & control)
• Progestins (therapeutic use)
• Treatment Outcome
• Young Adult