title: Impact of prior gestational age at preterm delivery on effectiveness of 17-alpha-hydroxyprogesterone caproate in practice.
abstract: OBJECTIVE
  We sought to examine if 17-alpha-hydroxyprogesterone caproate (17OHPC) effectiveness is dependent on the earliest gestational age (GA) at prior spontaneous preterm birth (SPTB) when administered in the clinical setting.
  
  
  METHODS
  Women enrolled for outpatient services with current singleton gestation and > or =1 prior SPTB between 20-36.9 weeks were identified. Data were divided into 3 groups according to earliest GA of prior SPTB (20-27.9, 28-33.9, and 34-36.9 weeks). We compared GA at delivery of current pregnancy and incidence of recurrent SPTB between women enrolled in outpatient 17OHPC administration program (n = 2978) and women receiving other outpatient services without 17OHPC (n = 1260).
  
  
  RESULTS
  Rates of recurrent SPTB for those with and without 17OHPC prophylaxis, respectively, according to GA at earliest SPTB were: 20-27.9 weeks at earliest SPTB, 32.2% vs 40.7%, P = .025; 28-33.9 weeks at earliest SPTB, 34.1% vs 45.5%, P < .001; and 34-36.9 weeks at earliest SPTB, 29.3% vs 38.8%, P < .001.
  
  
  CONCLUSIONS
  17OHPC given to prevent recurrent SPTB is effective regardless of GA at earliest SPTB.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, FL, USA.
authors.forename: Victor H
authors.initials: VH
authors.lastname: González-Quintero
authors.forename: Lesley
authors.initials: L
authors.lastname: de la Torre
authors.forename: Debbie J
authors.initials: DJ
authors.lastname: Rhea
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Tudela
authors.forename: Enrique
authors.initials: E
authors.lastname: Vazquez-Vera
authors.forename: Cheryl
authors.initials: C
authors.lastname: Desch
authors.forename: Niki B
authors.initials: NB
authors.lastname: Istwan
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D047928:Premature Birth / Q000453:epidemiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D055502:Secondary Prevention
chemical_list: D019326:17-alpha-Hydroxyprogesterone