17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30 mm - 30/10/12
Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network
Résumé |
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.
Le texte complet de cet article est disponible en PDF.Key words : nulliparous, progesterone, progestogen, short cervix
Plan
The project described was supported by grant numbers HD21410, UL1 RR024153, UL1 TR000005, HD27869, HD27915, HD27917, HD34116, HD34208, 5UL1RR025764, HD36801, HD40500, HD40512, HD40544, M01 RR00080, UL1 RR024989 (National Center for Research Resources [NCRR]), HD40545, HD40560, HD40485, HD53097, and HD53118 from the NICHD. |
|
www.clinicaltrials.gov number, NCT00439374. |
|
The authors report no conflict of interest. |
|
This paper does not necessarily represent the official views of the NCRR, NICHD, or National Institutes of Health. |
|
Reprints not available from the authors. |
|
Cite this article as: Grobman WA, Thom EA, Spong CY, et al. 17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30 mm. Am J Obstet Gynecol 2012;207:390.e1-8. |
|
Other members of the NICHD MFMU Network are listed in the Acknowledgments. |
Vol 207 - N° 5
P. 390.e1-390.e8 - novembre 2012 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?