Practical considerations with 17-Hydroxyprogesterone caproate for preterm birth prevention: does timing of initiation and compliance matter?
Practical considerations with 17-Hydroxyprogesterone caproate for preterm birth prevention: does timing of initiation and compliance matter?
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DOI：
10.1038/s41372-019-0401-2
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发表时间：
2019-09-01
影响因子：
2.9
通讯作者：
Stout, Molly J.
中科院分区：
文献类型：
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作者：
Carter, Ebony B.;Cahill, Alison G.;Stout, Molly J.
目的 确定开始使用 17-羟基孕酮己酸酯 (17-OHPC) 的孕龄是否与早产 (PTB) 风险相关。研究设计 我们使用 MarketScan (R) 数据进行了一项回顾性队列研究。主要结局是 PTB < 37 周。比较了 16-21 周和 21-29 周开始用药时的 PTB 发生率。在调整潜在的混杂变量后，测试了每周 17-OHPC 注射的依从性与早产率之间的关联。结果 所有 3374 名妊娠均符合纳入标准。较早开始 17-OHPC 的女性早产的可能性低于较晚开始的女性（aRR 0.88；95%CI 0.79-0.97；p = 0.02）。依从性较差的患者接受 85% 的推荐剂量（aRR 1.5；95%CI 1.2-1.7；p < 0.01）。结论 早期 17-OHPC 开始和依从性与 PTB 率降低之间存在关联。
Objective Determine whether gestational age of 17-hydroxyprogesterone caproate (17-OHPC) initiation is associated with preterm birth (PTB) risk.Study design We performed a retrospective cohort study using MarketScan (R) data. The primary outcome was PTB < 37 weeks. Rates of PTB were compared between medication initiation at 16-21 weeks versus 21-29 weeks. The association between compliance with weekly 17-OHPC injections and preterm birth rate was tested after adjusting for potential confounding variables.Result In all 3374 pregnancies met inclusion criteria. Women with an early 17-OHPC start were less likely to deliver preterm than those with a late start (aRR 0.88; 95%CI 0.79-0.97; p = 0.02). Less compliant patients receiving 85% of recommended doses (aRR 1.5; 95%CI 1.2-1.7; p < 0.01).Conclusion There is an association between both early 17-OHPC initiation and compliance with reduced rates of PTB.