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Published on: January 12, 2018
Practical considerations with 17-Hydroxyprogesterone caproate for preterm birth prevention: does timing of initiation
Ebony B Carter1, Alison G Cahill2, Margaret A Olsen3
1Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University School of Medicine, St. Louis, MO, USA. cartere@wustl.edu.
Objective:
Determine whether gestational age of 17-hydroxyprogesterone caproate (17-OHPC) initiation is associated with preterm birth (PTB) risk.
Study Design:
We performed a retrospective cohort study using MarketScan® data. The primary outcome was PTB < 37 weeks. Rates of PTB were compared between medication initiation at 16-21 weeks versus 21-29 weeks. The association between compliance with weekly 17-OHPC injections and preterm birth rate was tested after adjusting for potential confounding variables.
Result:
In all 3374 pregnancies met inclusion criteria. Women with an early 17-OHPC start were less likely to deliver preterm than those with a late start (aRR 0.88; 95%CI 0.79-0.97; p = 0.02). Less compliant patients receiving <25% of recommended doses had a higher PTB rate than those receiving >85% of recommended doses (aRR 1.5; 95%CI 1.2-1.7; p < 0.01).
Conclusion:
There is an association between both early 17-OHPC initiation and compliance with reduced rates of PTB.
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