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Preventing recurrent preterm birth with 125 mg of 17‐alpha‐hydroxyprogesterone caproate
Author(s) -
Fukuda Toma,
Kyozuka Hyo,
Murata Tsuyoshi,
Yasuda Shun,
Yamaguchi Akiko,
Fujimori Keiya
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14903
Subject(s) - medicine , odds ratio , gestational age , gestation , confidence interval , obstetrics , population , retrospective cohort study , gynecology , pregnancy , genetics , biology , environmental health
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.