title: Rates of recurrent preterm birth by maternal body habitus in women receiving 17α-hydroxyprogesterone caproate.
abstract: OBJECTIVE
  To examine the influence of maternal pre-pregnancy body mass index (BMI) on the rates of recurrent spontaneous preterm birth (SPTB) in women receiving 17α-hydroxyprogesterone caproate (17P).
  
  
  METHODS
  Retrospective analysis of a cohort of 6253 women with a singleton gestation and prior SPTB enrolled in 17P home administration program between 16.0 and 26.9 weeks. Data were grouped by pre-pregnancy BMI (lean <18.5 kg/m(2), normal 18.5-24.9 kg/m(2), overweight 25-29.9 kg/m(2) and obese ≥30.0 kg/m(2)). Delivery outcomes were compared using χ(2) and Kruskal-Wallis tests with statistical significance set at p < 0.05.
  
  
  RESULTS
  SPTB<28 weeks was significantly lower in normal weight women. Rates of recurrent SPTB<37 weeks were highest in the group with BMI<18.5 kg/m(2). Lean gravidas were younger, more likely to smoke, and less likely to be African-American than those with normal or increased BMI. In logistic regression, after controlling for race and prior preterm birth <28 weeks, the risk of SPTB<37 weeks decreased 2% for every additional 1 kg/m(2) increase in BMI.
  
  
  CONCLUSIONS
  Recurrent spontaneous preterm delivery<37 weeks in patients on 17P is more common in lean women (BMI<18.5 kg/m(2)), and less common in obese women (BMI ≥30 kg/m(2)) suggesting that the current recommended dosing of 17 P is adequate for women with higher BMI.
authors: Department of Obstetrics and Gynecology, MedStar Health Washington Hospital Center, Washington, DC, USA. julia.timofeev@medstar.net
authors: Julia
authors: J
authors: Timofeev
authors: Maisa
authors: M
authors: Feghali
authors: Annelee
authors: A
authors: Boyle
authors: Niki
authors: N
authors: Istwan
authors: Debbie
authors: D
authors: Rhea
authors: Rita W
authors: RW
authors: Driggers
mesh_terms: D000077713:17 alpha-Hydroxyprogesterone Caproate; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006908:Hydroxyprogesterones / Q000008:administration & dosage*; D007231:Infant, Newborn; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology* / Q000517:prevention & control*; D045167:Progesterone Congeners / Q000008:administration & dosage*; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006908:Hydroxyprogesterones; D045167:Progesterone Congeners; D000077713:17 alpha-Hydroxyprogesterone Caproate