17-alpha-hydroxyprogesterone caproate for the prevention of preterm birth in women with prior preterm birth and a short cervical length

Vincenzo Berghella, Dana Figueroa, Jeff M. Szychowski, John Owen, Gary Hankins, Jay D. Iams, Jeanne S. Sheffield, Annette Perez-Delboy, Deborah A. Wing, Edwin R. Guzman

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Objective: We sought to evaluate 17-alpha-hydroxyprogesterone caproate (17P) for prevention of preterm birth (PTB) in women with prior spontaneous PTB (SPTB) and cervical length (CL) <25 mm. Study Design: We conducted planned secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development-sponsored randomized trial evaluating cerclage for women with singleton gestations, prior SPTB (17-33 6/7 weeks), and CL <25 mm between 16-22 6/7 weeks. Women were stratified at randomization to intent to use or not use 17P. The effect of 17P was analyzed separately for cerclage and no-cerclage groups. Primary outcome was PTB <35 weeks. Results: In 300 women, 17P had no effect on PTB <35 weeks in either cerclage (P = .64) or no-cerclage (P = .51) groups. Only PTB <24 weeks (odds ratio, 0.08) and perinatal death (odds ratio, 0.14) were significantly lower for those with 17P in the no-cerclage group. Conclusion: 17P had no additional benefit for prevention of PTB in women who had prior SPTB and got ultrasound-indicated cerclage for CL <25 mm. In women who did not get cerclage, 17P reduced previable birth and perinatal mortality.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume202
Issue number4
DOIs
StatePublished - Apr 2010

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Premature Birth
Cervical Cerclage
Odds Ratio
National Institute of Child Health and Human Development (U.S.)
Perinatal Mortality
Random Allocation
17-alpha-hydroxy-progesterone caproate
Parturition
Pregnancy

Keywords

  • cerclage
  • preterm birth
  • progesterone
  • short cervical length

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

17-alpha-hydroxyprogesterone caproate for the prevention of preterm birth in women with prior preterm birth and a short cervical length. / Berghella, Vincenzo; Figueroa, Dana; Szychowski, Jeff M.; Owen, John; Hankins, Gary; Iams, Jay D.; Sheffield, Jeanne S.; Perez-Delboy, Annette; Wing, Deborah A.; Guzman, Edwin R.

In: American Journal of Obstetrics and Gynecology, Vol. 202, No. 4, 04.2010.

Research output: Contribution to journalArticle

Berghella, V, Figueroa, D, Szychowski, JM, Owen, J, Hankins, G, Iams, JD, Sheffield, JS, Perez-Delboy, A, Wing, DA & Guzman, ER 2010, '17-alpha-hydroxyprogesterone caproate for the prevention of preterm birth in women with prior preterm birth and a short cervical length', American Journal of Obstetrics and Gynecology, vol. 202, no. 4. https://doi.org/10.1016/j.ajog.2010.02.019
Berghella, Vincenzo ; Figueroa, Dana ; Szychowski, Jeff M. ; Owen, John ; Hankins, Gary ; Iams, Jay D. ; Sheffield, Jeanne S. ; Perez-Delboy, Annette ; Wing, Deborah A. ; Guzman, Edwin R. / 17-alpha-hydroxyprogesterone caproate for the prevention of preterm birth in women with prior preterm birth and a short cervical length. In: American Journal of Obstetrics and Gynecology. 2010 ; Vol. 202, No. 4.
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