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Preventing recurrent preterm birth with 125 mg of 17-alpha-hydroxyprogesterone caproate.
J Obstet Gynaecol Res. 2021 Sep; 47(9):3119-3126.JO

Abstract

AIM

There is strong evidence that weekly intramuscular (IM) injections of 250 mg of 17-alpha-hydroxyprogesterone caproate (17-OHPC) reduce the risk of recurrent preterm birth (PTB); however, whether a lower dose of 17-OHPC could reduce the risk of recurrent PTB remains unclear. This study aimed to assess whether 125 mg of 17-OHPC reduces recurrent PTB among women with a prior singleton spontaneous PTB and cervical length >25 mm.

METHODS

This retrospective cohort study at a tertiary-care medical center in Japan included women with a prior singleton spontaneous PTB between 20 and 36 weeks' gestation and cervical length >25 mm, between 2008 and 2018. Primary outcomes were PTB <37 and <34 weeks' gestation. We calculated the adjusted odds ratio (aOR) and 95% confidence interval (CI) using a multiple logistic regression model. Gestational age at delivery was compared using the Kaplan-Meier survival curve and log-rank test.

RESULTS

Overall, 173 women met the inclusion criteria. Eighty-four women received weekly injections of 125 mg of 17-OHPC, and 89 did not. Treatment with 125 mg of 17-OHPC significantly reduced the risk of recurrent spontaneous PTB <37 (aOR: 0.156 [95% CI: 0.049-0.497]) and <34 weeks' gestation (aOR: 0.156 [95% CI: 0.049-0.497]). The mean delivery gestational age was also significantly longer in the 17-OHPC group (log-rank p = 0.005).

CONCLUSIONS

In this study population, weekly IM injections of 125 mg of 17-OHPC reduced the risk of recurrent PTB <37 and <34 weeks' gestation.

Authors+Show Affiliations

Department of the Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan.Department of the Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan.Department of the Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan.Department of the Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan.Department of the Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan.Department of the Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34219326

Citation

Fukuda, Toma, et al. "Preventing Recurrent Preterm Birth With 125 Mg of 17-alpha-hydroxyprogesterone Caproate." The Journal of Obstetrics and Gynaecology Research, vol. 47, no. 9, 2021, pp. 3119-3126.
Fukuda T, Kyozuka H, Murata T, et al. Preventing recurrent preterm birth with 125 mg of 17-alpha-hydroxyprogesterone caproate. J Obstet Gynaecol Res. 2021;47(9):3119-3126.
Fukuda, T., Kyozuka, H., Murata, T., Yasuda, S., Yamaguchi, A., & Fujimori, K. (2021). Preventing recurrent preterm birth with 125 mg of 17-alpha-hydroxyprogesterone caproate. The Journal of Obstetrics and Gynaecology Research, 47(9), 3119-3126. https://doi.org/10.1111/jog.14903
Fukuda T, et al. Preventing Recurrent Preterm Birth With 125 Mg of 17-alpha-hydroxyprogesterone Caproate. J Obstet Gynaecol Res. 2021;47(9):3119-3126. PubMed PMID: 34219326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preventing recurrent preterm birth with 125 mg of 17-alpha-hydroxyprogesterone caproate. AU - Fukuda,Toma, AU - Kyozuka,Hyo, AU - Murata,Tsuyoshi, AU - Yasuda,Shun, AU - Yamaguchi,Akiko, AU - Fujimori,Keiya, Y1 - 2021/07/04/ PY - 2021/04/04/revised PY - 2020/10/14/received PY - 2021/06/08/accepted PY - 2021/7/6/pubmed PY - 2021/9/7/medline PY - 2021/7/5/entrez KW - 17-alpha-hydroxyprogesterone caproate KW - gestational diabetes KW - glucose intolerance KW - low birthweight KW - premature birth SP - 3119 EP - 3126 JF - The journal of obstetrics and gynaecology research JO - J Obstet Gynaecol Res VL - 47 IS - 9 N2 - AIM: There is strong evidence that weekly intramuscular (IM) injections of 250 mg of 17-alpha-hydroxyprogesterone caproate (17-OHPC) reduce the risk of recurrent preterm birth (PTB); however, whether a lower dose of 17-OHPC could reduce the risk of recurrent PTB remains unclear. This study aimed to assess whether 125 mg of 17-OHPC reduces recurrent PTB among women with a prior singleton spontaneous PTB and cervical length >25 mm. METHODS: This retrospective cohort study at a tertiary-care medical center in Japan included women with a prior singleton spontaneous PTB between 20 and 36 weeks' gestation and cervical length >25 mm, between 2008 and 2018. Primary outcomes were PTB <37 and <34 weeks' gestation. We calculated the adjusted odds ratio (aOR) and 95% confidence interval (CI) using a multiple logistic regression model. Gestational age at delivery was compared using the Kaplan-Meier survival curve and log-rank test. RESULTS: Overall, 173 women met the inclusion criteria. Eighty-four women received weekly injections of 125 mg of 17-OHPC, and 89 did not. Treatment with 125 mg of 17-OHPC significantly reduced the risk of recurrent spontaneous PTB <37 (aOR: 0.156 [95% CI: 0.049-0.497]) and <34 weeks' gestation (aOR: 0.156 [95% CI: 0.049-0.497]). The mean delivery gestational age was also significantly longer in the 17-OHPC group (log-rank p = 0.005). CONCLUSIONS: In this study population, weekly IM injections of 125 mg of 17-OHPC reduced the risk of recurrent PTB <37 and <34 weeks' gestation. SN - 1447-0756 UR - https://www.unboundmedicine.com/medline/citation/34219326/Preventing_recurrent_preterm_birth_with_125_mg_of_17_alpha_hydroxyprogesterone_caproate_ L2 - https://doi.org/10.1111/jog.14903 DB - PRIME DP - Unbound Medicine ER -