Does progesterone treatment influence risk factors for recurrent preterm delivery?

Paul J. Meis, Mark Klebanoff, Mitchell P. Dombrowski, Baha M. Sibai, Sharon Leindecker, Atef H. Moawad, Allison Northen, Jay D. Iams, Michael W. Varner, Steve N. Caritis, Mary J. O'Sullivan, Menachem Miodovnik, Kenneth J. Leveno, Deborah Conway, Ronald J. Wapner, Marshall Carpenter, Brian Mercer, Susan M. Ramin, John M. Thorp, Alan M. PeacemanSteven Gabbe

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objective: To examine how demographic and pregnancy characteristics can affect the risk of recurrent preterm delivery and the how the effectiveness of progesterone treatment for prevention alters these relationships. Methods: This was a secondary analysis of a randomized trial of 17α-hydroxyprogesterone caproate to prevent recurrent preterm delivery in women at risk. Associations of risk factors for preterm delivery (less than 37 completed weeks of gestation) were examined separately for the women in the 17α-hydroxyprogesterone caproate (n = 310) and placebo (n = 153) groups. Results: Univariate analysis found that the number of previous preterm deliveries and whether the penultimate delivery was preterm were significant risk factors for preterm delivery in both the placebo and progesterone groups. High body mass index was protective of preterm birth in the placebo group. Multivariate analysis found progesterone treatment to cancel the risk of more than 1 previous preterm delivery, but not the risk associated with the penultimate pregnancy delivered preterm. Obesity was associated with lower risk for preterm delivery in the placebo group but not in the women treated with progesterone. Conclusion: The use of 17α-hydroxyprogesterone caproate in women with a previous preterm delivery reduces the overall risk of preterm delivery and changes the epidemiology of risk factors for recurrent preterm delivery. In particular, these data suggest that 17α-hydroxyprogesterone caproate reduces the risk of a history of more than 1 preterm delivery.

Original languageEnglish
Pages (from-to)557-561
Number of pages5
JournalObstetrics and Gynecology
Volume106
Issue number3
StatePublished - Sep 1 2005
Externally publishedYes

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Progesterone
17-alpha-Hydroxyprogesterone
Placebos
Pregnancy
Therapeutics
Premature Birth
Epidemiology
Body Mass Index
Multivariate Analysis
Obesity
Demography
17-alpha-hydroxy-progesterone caproate

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Meis, P. J., Klebanoff, M., Dombrowski, M. P., Sibai, B. M., Leindecker, S., Moawad, A. H., ... Gabbe, S. (2005). Does progesterone treatment influence risk factors for recurrent preterm delivery? Obstetrics and Gynecology, 106(3), 557-561.

Does progesterone treatment influence risk factors for recurrent preterm delivery? / Meis, Paul J.; Klebanoff, Mark; Dombrowski, Mitchell P.; Sibai, Baha M.; Leindecker, Sharon; Moawad, Atef H.; Northen, Allison; Iams, Jay D.; Varner, Michael W.; Caritis, Steve N.; O'Sullivan, Mary J.; Miodovnik, Menachem; Leveno, Kenneth J.; Conway, Deborah; Wapner, Ronald J.; Carpenter, Marshall; Mercer, Brian; Ramin, Susan M.; Thorp, John M.; Peaceman, Alan M.; Gabbe, Steven.

In: Obstetrics and Gynecology, Vol. 106, No. 3, 01.09.2005, p. 557-561.

Research output: Contribution to journalArticle

Meis, PJ, Klebanoff, M, Dombrowski, MP, Sibai, BM, Leindecker, S, Moawad, AH, Northen, A, Iams, JD, Varner, MW, Caritis, SN, O'Sullivan, MJ, Miodovnik, M, Leveno, KJ, Conway, D, Wapner, RJ, Carpenter, M, Mercer, B, Ramin, SM, Thorp, JM, Peaceman, AM & Gabbe, S 2005, 'Does progesterone treatment influence risk factors for recurrent preterm delivery?', Obstetrics and Gynecology, vol. 106, no. 3, pp. 557-561.
Meis PJ, Klebanoff M, Dombrowski MP, Sibai BM, Leindecker S, Moawad AH et al. Does progesterone treatment influence risk factors for recurrent preterm delivery? Obstetrics and Gynecology. 2005 Sep 1;106(3):557-561.
Meis, Paul J. ; Klebanoff, Mark ; Dombrowski, Mitchell P. ; Sibai, Baha M. ; Leindecker, Sharon ; Moawad, Atef H. ; Northen, Allison ; Iams, Jay D. ; Varner, Michael W. ; Caritis, Steve N. ; O'Sullivan, Mary J. ; Miodovnik, Menachem ; Leveno, Kenneth J. ; Conway, Deborah ; Wapner, Ronald J. ; Carpenter, Marshall ; Mercer, Brian ; Ramin, Susan M. ; Thorp, John M. ; Peaceman, Alan M. ; Gabbe, Steven. / Does progesterone treatment influence risk factors for recurrent preterm delivery?. In: Obstetrics and Gynecology. 2005 ; Vol. 106, No. 3. pp. 557-561.
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AU - Klebanoff, Mark

AU - Dombrowski, Mitchell P.

AU - Sibai, Baha M.

AU - Leindecker, Sharon

AU - Moawad, Atef H.

AU - Northen, Allison

AU - Iams, Jay D.

AU - Varner, Michael W.

AU - Caritis, Steve N.

AU - O'Sullivan, Mary J.

AU - Miodovnik, Menachem

AU - Leveno, Kenneth J.

AU - Conway, Deborah

AU - Wapner, Ronald J.

AU - Carpenter, Marshall

AU - Mercer, Brian

AU - Ramin, Susan M.

AU - Thorp, John M.

AU - Peaceman, Alan M.

AU - Gabbe, Steven

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N2 - Objective: To examine how demographic and pregnancy characteristics can affect the risk of recurrent preterm delivery and the how the effectiveness of progesterone treatment for prevention alters these relationships. Methods: This was a secondary analysis of a randomized trial of 17α-hydroxyprogesterone caproate to prevent recurrent preterm delivery in women at risk. Associations of risk factors for preterm delivery (less than 37 completed weeks of gestation) were examined separately for the women in the 17α-hydroxyprogesterone caproate (n = 310) and placebo (n = 153) groups. Results: Univariate analysis found that the number of previous preterm deliveries and whether the penultimate delivery was preterm were significant risk factors for preterm delivery in both the placebo and progesterone groups. High body mass index was protective of preterm birth in the placebo group. Multivariate analysis found progesterone treatment to cancel the risk of more than 1 previous preterm delivery, but not the risk associated with the penultimate pregnancy delivered preterm. Obesity was associated with lower risk for preterm delivery in the placebo group but not in the women treated with progesterone. Conclusion: The use of 17α-hydroxyprogesterone caproate in women with a previous preterm delivery reduces the overall risk of preterm delivery and changes the epidemiology of risk factors for recurrent preterm delivery. In particular, these data suggest that 17α-hydroxyprogesterone caproate reduces the risk of a history of more than 1 preterm delivery.

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