Gestational age at initiation of 17-hydroxyprogesterone caproate (17P) and recurrent preterm delivery

Abstract

Objective. To compare rates of recurrent preterm birth between women starting treatment with 17α-hydroxyprogesterone caproate (17P) at 16–20.9 weeks of gestation versus 21–26.9 weeks.

Methods. Women enrolled in an outpatient program of education, nursing assessment and weekly 17P injections beginning at 16–26.9 weeks were eligible. Included were patients with singleton pregnancies and a history of preterm delivery (PTD). Pregnancy outcome was compared between women starting 17P at 16–20.9 weeks (n = 156) and those starting 17P at 21–26.9 weeks (n = 119) using Fisher's exact and Mann–Whitney U test statistics (p < 0.05 considered significant).

Results. Mean gestational age at delivery (36.8 ± 3.0 vs. 36.7 ± 2.5) and rates of PTD at <37 weeks (40.4% vs. 48.7%), <35 weeks (16.7% vs. 16.8%) and <32 weeks (5.1% vs. 5.0%) were similar between the groups; all p > 0.05.

Conclusions. Rates of preterm delivery were similar in patients initiating 17P at 16–20.9 or 21–26.9 weeks. A larger sample size is warranted in order to confirm our findings.

Keywords:

• Preterm delivery
• preterm birth prevention
• 17α-hydroxyprogesterone caproate