The use of 17-hydroxy progesterone in women with arrested preterm labor: a randomized clinical trial

J Matern Fetal Neonatal Med. 2014 Dec;27(18):1892-6. doi: 10.3109/14767058.2014.892922. Epub 2014 Mar 10.

Abstract

Background: The use of 17-alpha-hydroxyprogesterone caproate (17 P) has been shown to reduce preterm delivery in women who have had a prior preterm birth. The role of 17 P in women with arrested preterm labor is less certain.

Aims: To compare the preterm birth rate and neonatal outcome in women with arrested preterm labor randomized to receive 17 P or placebo.

Materials and methods: Women with arrested preterm labor were randomized to weekly injections of either 17 P (250 mg) or placebo. Maternal and neonatal outcome were evaluated.

Results: Forty-five singleton pregnancies were randomized after successful tocolysis; 22 received 17 P while 23 got placebo. Gestational age at delivery (p = 0.067) and the interval from treatment to delivery (p = 0.233) were not affected by 17 P. Significantly less women in the 17 P group delivered at <34 weeks (14 versus 21, p = 0.035). There was also a significant reduction in the risk of neonatal sepsis (p = 0.047) and gr III/IV intraventricular hemorrhage (IVH) (p = 0.022) in the 17 P group.

Conclusion: In this study, 17 P did not delay the interval to delivery after successful preterm labor, but births <34 weeks as well as neonatal sepsis and IVH were reduced by 17 P treatment.

Trial registration: ClinicalTrials.gov NCT00830765.

Keywords: 17 hydroxyprogesterone; neonatal morbidity; preterm delivery; preterm labor.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • 17 alpha-Hydroxyprogesterone Caproate
  • Apgar Score
  • Birth Weight
  • Female
  • Gestational Age
  • Humans
  • Hydroxyprogesterones / therapeutic use*
  • Infant, Newborn
  • Obstetric Labor, Premature / drug therapy*
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Premature Birth / drug therapy
  • Premature Birth / epidemiology
  • Tocolysis / methods*

Substances

  • Hydroxyprogesterones
  • 17 alpha-Hydroxyprogesterone Caproate

Associated data

  • ClinicalTrials.gov/NCT00830765