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Am J Perinatol. 2014 Jan;31(1):55-60. doi: 10.1055/s-0033-1334452. Epub 2013 Mar 1.

Spontaneous preterm birth in African-American and Caucasian women receiving 17α-hydroxyprogesterone caproate.

Author information

1
Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
2
Department of Clinical Research, Alere Health, Women's and Children's Health, Atlanta, Georgia.

Abstract

OBJECTIVE:

To determine if the rates of recurrent spontaneous preterm birth in women receiving 17α-hydroxyprogesterone caproate (17P) differ according to maternal race.

STUDY DESIGN:

Retrospective analysis of a cohort of women enrolled in outpatient 17P administration at < 27 weeks. Maternal characteristics, obstetric history, and rates of recurrent preterm birth were determined using chi-square and multivariable Cox proportional hazards regression at two-tailed α = 0.05. Primary study outcome was defined as having a spontaneous preterm birth < 34 weeks.

RESULTS:

African-American women initiated 17P injections later (19.6 versus 18.9 weeks, p < 0.001) and discontinued injections earlier (33.2 versus 34.1 weeks, p < 0.001) than Caucasian women. Spontaneous recurrent preterm birth < 34 weeks was higher in African-Americans versus Caucasians receiving 17P (odds ratio 2.1; 95% confidence interval 1.7, 2.4). After adjusting for other significant factors, African-American race retained the strongest association with recurrent spontaneous preterm birth < 34 weeks. Within each racial group, short cervical length < 25 mm before 27 weeks' gestation had the highest hazard of recurrent spontaneous preterm delivery.

CONCLUSION:

Despite treatment with 17P, African-American women have higher rates of recurrent preterm birth.

PMID:
23456908
DOI:
10.1055/s-0033-1334452
[Indexed for MEDLINE]

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