Influence of gestational age and reason for prior preterm birth on rates of recurrent preterm delivery

• Published in: American journal of obstetrics and gynecology Vol. 205; no. 3; pp. 275.e1 - 275.e5
• Main Authors: Gonzalez-Quintero, Victor Hugo, MD, MPH, Cordova, Yvette C., MD, Istwan, Niki B., RN, Tudela, Felipe, MD, Rhea, Debbie J., MPH, Romary, Letty Maria, MD, Marimon, Adrian, MD, Desch, Cheryl N., RN, MS, Stanziano, Gary J., MD
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01-09-2011; Elsevier
• Subjects: 17-α-hydroxyprogesterone caproate; Adult; Age Factors; Biological and medical sciences; Diseases of mother, fetus and pregnancy; Female; Fetal Membranes, Premature Rupture - drug therapy; Fetal Membranes, Premature Rupture - etiology; Fetal Membranes, Premature Rupture - prevention & control; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Hydroxyprogesterones - therapeutic use; Infant, Newborn; Infant, Premature; Medical sciences; Obstetrics and Gynecology; Pregnancy; Pregnancy. Fetus. Placenta; Premature Birth - drug therapy; Premature Birth - etiology; Premature Birth - prevention & control; preterm labor; preterm premature rupture of membranes; Progestins - therapeutic use; recurrent preterm birth; Secondary Prevention; preterm premature rupture of membranes; preterm labor; 17-α-hydroxyprogesterone caproate; recurrent preterm birth; Relapse; Pregnancy disorders; Prematurity; Gynecology; Premature delivery; Obstetrics; Gestational age
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2011.06.043

Objective We sought to compare rates of recurrent spontaneous preterm birth (SPTB) in women receiving 17-α-hydroxyprogesterone caproate (17P) with prior SPTB due to preterm labor (PTL) vs preterm premature rupture of membranes (PPROM). Study Design Women with singleton gestation having 1 prior SPTB enrolled at 16-24.9 weeks' gestation for weekly outpatient 17P administration were identified from a database. Rates of recurrent SPTB were compared between those with prior SPTB due to PTL or PPROM overall and by gestational age at prior SPTB. Results Records from 2123 women were analyzed. The prior PTL group vs the prior PPROM group experienced higher rates of recurrent SPTB at <37 weeks (29.7% vs 22.9%, P = .004), <35 weeks (14.0% vs 9.1%, P = .004), and <32 weeks (5.9% vs 3.3%, P = .024), respectively. Conclusion Reason and gestational age of prior SPTB influence the likelihood of recurrent SPTB in women receiving 17P prophylaxis.