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Estimated effect of 17 alpha-hydroxyprogesterone caproate on preterm birth in the United States.

Abstract：

OBJECTIVE:A multicenter, randomized placebo-controlled trial among women with singleton pregnancies and a history of spontaneous preterm birth found that weekly injections of 17 alpha-hydroxyprogesterone caproate (17P), initiated between 16 and 20 weeks of gestation, reduced preterm birth by 33%. The current study estimated both preterm birth recurrence and the potential reduction in the national preterm birth rate. METHODS:Using 2002 national birth certificate data, augmented by vital statistics from 2 states, we estimated the number of singleton births delivered to women eligible for 17P through both a history of spontaneous preterm birth and prenatal care onset within the first 4 months of pregnancy. The number and rate of recurrent spontaneous preterm births were estimated. To predict effect, the reported 33% reduction in spontaneous preterm birth attributed to 17P therapy was applied to these estimates. RESULTS:In 2002, approximately 30,000 recurrent preterm births occurred to women eligible for 17P, having had a recurrent preterm birth rate of 22.5%. If 17P therapy were delivered to these women, nearly 10,000 spontaneous preterm births would have been prevented, thereby reducing the overall United States preterm birth rate by approximately 2%, from 12.1% to 11.8% (P < .001), with higher reductions in targeted groups of eligible pregnant women. CONCLUSION:Use of 17P could reduce preterm birth among eligible women, but would likely have a modest effect on the national preterm birth rate. Additional research is urgently needed to identify other populations who might benefit from 17P, evaluate new methods for early detection of women at risk, and develop additional prevention strategies. LEVEL OF EVIDENCE:III.

journal_name

Obstet Gynecol

journal_title

Obstetrics and gynecology

authors

Petrini JR,Callaghan WM,Klebanoff M,Green NS,Lackritz EM,Howse JL,Schwarz RH,Damus K

doi

10.1097/01.AOG.0000150560.24297.4f

subject

Has Abstract

pub_date

2005-02-01 00:00:00

pages

267-72

issue

eissn

0029-7844

issn

1873-233X

pii

105/2/267

journal_volume

105

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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Estimated effect of 17 alpha-hydroxyprogesterone caproate on preterm birth in the United States.