title: Spontaneous preterm birth in African-American and Caucasian women receiving 17α-hydroxyprogesterone caproate.
abstract: OBJECTIVE
  To determine if the rates of recurrent spontaneous preterm birth in women receiving 17α-hydroxyprogesterone caproate (17P) differ according to maternal race.
  
  
  METHODS
  Retrospective analysis of a cohort of women enrolled in outpatient 17P administration at < 27 weeks. Maternal characteristics, obstetric history, and rates of recurrent preterm birth were determined using chi-square and multivariable Cox proportional hazards regression at two-tailed α = 0.05. Primary study outcome was defined as having a spontaneous preterm birth < 34 weeks.
  
  
  RESULTS
  African-American women initiated 17P injections later (19.6 versus 18.9 weeks, p < 0.001) and discontinued injections earlier (33.2 versus 34.1 weeks, p < 0.001) than Caucasian women. Spontaneous recurrent preterm birth < 34 weeks was higher in African-Americans versus Caucasians receiving 17P (odds ratio 2.1; 95% confidence interval 1.7, 2.4). After adjusting for other significant factors, African-American race retained the strongest association with recurrent spontaneous preterm birth < 34 weeks. Within each racial group, short cervical length < 25 mm before 27 weeks' gestation had the highest hazard of recurrent spontaneous preterm delivery.
  
  
  CONCLUSIONS
  Despite treatment with 17P, African-American women have higher rates of recurrent preterm birth.
authors: Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
authors: Julia
authors: J
authors: Timofeev
authors: Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
authors: Jasbir
authors: J
authors: Singh
authors: Department of Clinical Research, Alere Health, Women's and Children's Health, Atlanta, Georgia.
authors: Niki
authors: N
authors: Istwan
authors: Department of Clinical Research, Alere Health, Women's and Children's Health, Atlanta, Georgia.
authors: Debbie
authors: D
authors: Rhea
authors: Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
authors: Rita W
authors: RW
authors: Driggers
mesh_terms: D000077713:17 alpha-Hydroxyprogesterone Caproate; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000033:anatomy & histology; D004965:Estrogen Antagonists / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006908:Hydroxyprogesterones / Q000627:therapeutic use*; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D047928:Premature Birth / Q000208:ethnology* / Q000517:prevention & control*; D012189:Retrospective Studies; D055502:Secondary Prevention; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D004965:Estrogen Antagonists; D006908:Hydroxyprogesterones; D000077713:17 alpha-Hydroxyprogesterone Caproate