17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30 mm

被引：61

作者：

Grobman, William A. ^{[1
]}

Thom, Elizabeth A. ^{[2
]}

Spong, Catherine Y. ^{[17
]}

Iams, Jay D. ^{[3
]}

Saade, George R. ^{[4
]}

Mercer, Brian M. ^{[5
]}

Tita, Alan T. N. ^{[6
]}

Rouse, Dwight J. ^{[7
]}

Sorokin, Yoram ^{[8
]}

Wapner, Ronald J. ^{[9
]}

Leveno, Kenneth J. ^{[10
]}

Blackwell, Sean ^{[11
]}

Esplin, M. Sean ^{[12
]}

Tolosa, Jorge E. ^{[13
]}

Thorp, John M., Jr. ^{[14
]}

Caritis, Steve N. ^{[15
]}

Van Dorsten, J. Peter ^{[16
]}

机构：

[1] Northwestern Univ, Chicago, IL 60611 USA

[2] George Washington Univ, Ctr Biostat, Washington, DC USA

[3] Ohio State Univ, Columbus, OH 43210 USA

[4] Univ Texas Med Branch, Galveston, TX USA

[5] Case Western Reserve Univ, Metrohlth Med Ctr, Cleveland, OH USA

[6] Univ Alabama Birmingham, Birmingham, AL USA

[7] Brown Univ, Providence, RI 02912 USA

[8] Wayne State Univ, Detroit, MI USA

[9] Columbia Univ, New York, NY USA

[10] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA

[11] Univ Texas Hlth Sci Ctr Houston, Houston, TX USA

[12] Univ Utah, Hlth Sci Ctr, Salt Lake City, UT USA

[13] Oregon Hlth & Sci Univ, Portland, OR 97201 USA

[14] Univ N Carolina, Chapel Hill, NC USA

[15] Univ Pittsburgh, Pittsburgh, PA USA

[16] Med Univ S Carolina, Charleston, SC 29425 USA

[17] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Bethesda, MD USA

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2012年 / 207卷 / 05期

关键词：

nulliparous; progesterone; progestogen; short cervix; PRETERM BIRTH; DOUBLE-BLIND; 17-ALPHA-HYDROXYPROGESTERONE CAPROATE; WEEKS GESTATION; RISK; PROGESTERONE; WOMEN; PREDICTION; DELIVERY;

D O I：

10.1016/j.ajog.2012.09.013

中图分类号：

R71 [妇产科学];

学科分类号：

100211 [妇产科学];

摘要：

OBJECTIVE: We sought to evaluate whether 17 alpha-hydroxyprogesterone caproate (17-OHP) reduces preterm birth (PTB) in nulliparous women with a midtrimester cervical length (CL) <30 mm. STUDY DESIGN: In this multicenter randomized controlled trial, nulliparous women with a singleton gestation between 16 and 22 3/7 weeks with an endovaginal CL <30 mm (<10th percentile in this population) were randomized to weekly intramuscular 17-OHP (250 mg) or placebo through 36 weeks. The primary outcome was PTB <37 weeks. RESULTS: The frequency of PTB did not differ between the 17-OHP (n = 327) and placebo (n = 330) groups (25.1% vs 24.2%; relative risk, 1.03; 95% confidence interval, 0.79-1.35). There also was no difference in the composite adverse neonatal outcome (7.0% vs 9.1%; relative risk, 0.77; 95% confidence interval, 0.46-1.30). CONCLUSION: Weekly 17-OHP does not reduce the frequency of PTB in nulliparous women with a midtrimester CL <30 mm.

引用

页码：390.e1 / 390.e8

页数：8

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