Journal Article

Prevention of Recurrent Preterm Delivery by 17 Alpha-Hydroxyprogesterone Caproate

Moawad, Atef H, Hauth, John C, Wapner, Ronald J, Thorp, John M, Spong, Catherine Y, Thom, Elizabeth, Caritis, Steve N, Miodovnik, Menachem, Carpenter, Marshall, Sibai, Baha, Varner, Michael W, O'Sullivan, Mary J, Ramin, Susan M, Conway, Deborah, Mercer, Brian, Leveno, Kenneth J, Iams, Jay D, Peaceman, Alan M, Dombrowski, Mitchell P, Meis, Paul J, Klebanoff, Mark

2003

Overview

Women with a history of preterm delivery are at high risk for recurrence in subsequent pregnancies, and an effective strategy to reduce this risk has been lacking. In this randomized, placebo-controlled trial, weekly injections of 17 alpha-hydroxyprogesterone caproate reduced the risk of delivery before 37 weeks of gestation by one third among such high-risk women. Injections of 17 alpha-hydroxyprogesterone reduced the risk among high-risk women. Preterm delivery — that is, delivery before 37 completed weeks of gestation — is the major determinant of infant mortality in developed countries. 1 Preterm delivery is more common in the United States than in many other developed countries and is the factor most responsible for the relatively high infant mortality in this country. 1 The rate of preterm delivery in the United States has increased progressively from 9 percent to 12 percent over the past two decades. 2 Despite many trials of reduced activity, tocolytic therapy, antibiotic therapy, and other strategies for prevention, no effective and reproducible method of preventing preterm delivery . . .

• Publisher: Massachusetts Medical Society
• Subject: 17 alpha-Hydroxyprogesterone Caproate / Adult / Biological and medical sciences / Birth Weight / Cerebral Hemorrhage - epidemiology / Diseases of mother, fetus and pregnancy / Double-Blind Method / Enterocolitis, Necrotizing - epidemiology / Female / Gynecology. Andrology. Obstetrics / Hormones. Endocrine system / Humans / Hydroxyprogesterones - adverse effects / Hydroxyprogesterones - therapeutic use / Industrialized nations / Infant mortality / Infant, Newborn / Infant, Premature / Medical sciences / Obstetric Labor, Premature - prevention & control / Obstetrics / Oxygen Inhalation Therapy / Pharmacology. Drug treatments / Pregnancy / Pregnancy Outcome / Pregnancy. Fetus. Placenta / Premature birth / Progesterone Congeners - adverse effects / Progesterone Congeners - therapeutic use / Risk / Survival Analysis / Womens health