What we have learned about the role of 17-alpha-hydroxyprogesterone caproate in the prevention of preterm birth

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• 作者：Steve N. Caritis ; MD^a ; ^{carisn@mail.magee.edu" class="auth_mail" title="E-mail the corresponding author} ; Maisa N. Feghali ; MD^a ; William A. Grobman ; MD ; MBA^b ; Dwight J. Rouse ; MD^c ; for the Eunice Kennedy Shriver National Institute of Child Health ; Human Development Maternal&ndash ; Fetal Medicine Units Network
• 关键词：Preterm birth ; Prevention ; 17-alpha-hydroxyprogesterone caproate
• 刊名：Seminars in Perinatology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：40
• 期：5
• 页码：273-280
• 全文大小：463 K

文摘

Despite major advances in neonatal care, the burden of preterm birth remains high. This is not unexpected since strategies to identify and treat risk factors in early pregnancy have not been very effective in reducing the preterm birth rate. Initial studies suggested a potential benefit for 17-alpha-hydroxyprogesterone caproate (17-OHPC) in decreasing the risk of recurrent preterm birth women with a singleton gestation. However, the use of 17-OHPC has not conferred benefit for other categories of women at high risk for preterm delivery (twins, triplets, and short cervical length). The increasing body of evidence suggests that preterm birth is a complex condition with variable mechanisms of disease and significant individual heterogeneity. This review will examine the plausibility of 17-OHPC in preventing preterm birth and the investigation of its clinical efficacy. We will also highlight factors to explain variations in clinical trial outcomes and outline the trajectory needed for future investigations.