The influence of prior obstetrical history on current 17-hydroxyprogesterone caproate use

J Pregnancy. 2011:2011:286483. doi: 10.1155/2011/286483. Epub 2011 Jul 6.

Abstract

Objective: To determine if gestational age of prior preterm delivery influences a woman's receipt of 17-hydroxyprogesterone caproate (17-OHP-C).

Methods: Retrospective cohort of women eligible for 17-OHP-C at Duke Obstetrics Clinic were identified by medical record review. Sociodemographic and clinical characteristics were abstracted. Results. Of 104 eligible subjects, 82 (78.8%) were offered 17-OHP-C. Of these, thirty-four (41.5%) declined. The median gestational age of the most recent preterm delivery was significantly lower among subjects who accepted 17-OHP-C as compared to those who declined (28.7 vs. 34.0 weeks, P = .02) and in subjects offered 17-OHP-C compared to those not offered 17-OHP-C (30.2 vs. 36.0 weeks, P = .03). Subjects not offered 17-OHP-C were more likely to have had an interval term delivery (31.8% vs. 9.7%, P = .009)

Conclusion: Women with earlier preterm deliveries were more likely to be offered and accept 17-OHP-C. Prior obstetric history may influence both providers' and patients' willingness to discuss and/or accept 17-OHP-C.

MeSH terms

  • 17 alpha-Hydroxyprogesterone Caproate
  • Adult
  • Female
  • Gestational Age*
  • Humans
  • Hydroxyprogesterones / therapeutic use*
  • Patient Acceptance of Health Care / psychology*
  • Practice Patterns, Physicians'
  • Pregnancy
  • Pregnancy, High-Risk
  • Premature Birth / prevention & control*
  • Premature Birth / psychology
  • Progestins / therapeutic use*
  • Retrospective Studies
  • Secondary Prevention
  • Term Birth / psychology
  • Treatment Refusal / psychology
  • Young Adult

Substances

  • Hydroxyprogesterones
  • Progestins
  • 17 alpha-Hydroxyprogesterone Caproate