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

Am J Obstet Gynecol. 2011 Sep;205(3):275.e1-5. doi: 10.1016/j.ajog.2011.06.043. Epub 2011 Jun 17.

Abstract

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.

MeSH terms

  • 17 alpha-Hydroxyprogesterone Caproate
  • Adult
  • Age Factors
  • Female
  • Fetal Membranes, Premature Rupture / drug therapy
  • Fetal Membranes, Premature Rupture / etiology
  • Fetal Membranes, Premature Rupture / prevention & control*
  • Gestational Age*
  • Humans
  • Hydroxyprogesterones / therapeutic use*
  • Infant, Newborn
  • Infant, Premature
  • Pregnancy
  • Premature Birth / drug therapy
  • Premature Birth / etiology
  • Premature Birth / prevention & control*
  • Progestins / therapeutic use*
  • Secondary Prevention

Substances

  • Hydroxyprogesterones
  • Progestins
  • 17 alpha-Hydroxyprogesterone Caproate