Literature DB >> 19155896

Prevention of preterm birth in triplets using 17 alpha-hydroxyprogesterone caproate: a randomized controlled trial.

Steve N Caritis1, Dwight J Rouse, Alan M Peaceman, Anthony Sciscione, Valerija Momirova, Catherine Y Spong, Jay D Iams, Ronald J Wapner, Michael Varner, Marshall Carpenter, Julie Lo, John Thorp, Brian M Mercer, Yoram Sorokin, Margaret Harper, Susan Ramin, Garland Anderson.   

Abstract

OBJECTIVE: To assess whether 17 alpha-hydroxyprogesterone caproate reduces the rate of preterm birth in women carrying triplets.
METHODS: We performed this randomized, double-blinded, placebo-controlled trial in 14 centers. Healthy women with triplets were randomly assigned to weekly intramuscular injections of either 250 mg of 17 alpha-hydroxyprogesterone caproate or matching placebo, starting at 16-20 weeks and ending at delivery or 35 weeks of gestation. The primary study outcome was delivery or fetal loss before 35 weeks.
RESULTS: One hundred thirty-four women were assigned, 71 to 17 alpha-hydroxyprogesterone caproate and 63 to placebo; none were lost to follow-up. Baseline demographic data were similar in the two groups. The proportion of women experiencing the primary outcome (a composite of delivery or fetal loss before 35 0/7 weeks) was similar in the two treatment groups: 83% of pregnancies in the 17 alpha-hydroxyprogesterone caproate group and 84% in the placebo group, relative risk 1.0, 95% confidence interval 0.9-1.1. The lack of benefit of 17 alpha-hydroxyprogesterone caproate was evident regardless of the conception method or whether a gestational age cutoff for delivery was set at 32 or 28 weeks.
CONCLUSION: Treatment with 17 alpha-hydroxyprogesterone caproate did not reduce the rate of preterm birth in women with triplet gestations. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00099164 LEVEL OF EVIDENCE: I.

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Year:  2009        PMID: 19155896      PMCID: PMC2790283          DOI: 10.1097/AOG.0b013e318193c677

Source DB:  PubMed          Journal:  Obstet Gynecol        ISSN: 0029-7844            Impact factor:   7.661


  16 in total

1.  Efficacy of 17alpha-hydroxyprogesterone caproate in the prevention of premature labor.

Authors:  J W Johnson; K L Austin; G S Jones; G H Davis; T M King
Journal:  N Engl J Med       Date:  1975-10-02       Impact factor: 91.245

2.  Introduction of marked as well as prolonged biologic activity by esterification; 17-alpha-hydroxyprogesterone caproate, a unique progestational compound.

Authors:  E C REIFENSTEIN
Journal:  Fertil Steril       Date:  1957 Jan-Feb       Impact factor: 7.329

3.  17-Alpha-hydroxyprogesterone-caproate: a new substance with prolonged progestational activity; a comparison with chemically pure progesterone.

Authors:  M E DAVIS; G L WIED
Journal:  J Clin Endocrinol Metab       Date:  1955-08       Impact factor: 5.958

4.  Progestogen administration in pregnancy may prevent preterm delivery.

Authors:  M J Keirse
Journal:  Br J Obstet Gynaecol       Date:  1990-02

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Journal:  Control Clin Trials       Date:  1988-12

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Authors:  A Cnaan; L Ryan
Journal:  Stat Med       Date:  1989-10       Impact factor: 2.373

7.  Expression of connexin-43 and connexin-26 in the rat myometrium during pregnancy and labor is differentially regulated by mechanical and hormonal signals.

Authors:  C W Ou; A Orsino; S J Lye
Journal:  Endocrinology       Date:  1997-12       Impact factor: 4.736

8.  Infant mortality statistics from the 2003 period linked birth/infant death data set.

Authors:  T J Mathews; Marian F MacDorman
Journal:  Natl Vital Stat Rep       Date:  2006-05-03

9.  Endocrine effects of 17 alpha-hydroxyprogesterone caproate during early pregnancy: a double-blind clinical trial.

Authors:  F J Reijnders; C M Thomas; W H Doesburg; R Rolland; T K Eskes
Journal:  Br J Obstet Gynaecol       Date:  1988-05

10.  Progesterone and gravidity differentially regulate expression of extracellular matrix components in the pregnant rat myometrium.

Authors:  Oksana Shynlova; Jennifer A Mitchell; Anne Tsampalieros; B Lowell Langille; Stephen J Lye
Journal:  Biol Reprod       Date:  2003-11-26       Impact factor: 4.285

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  21 in total

Review 1.  Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.

Authors:  Jodie M Dodd; Rosalie M Grivell; Cecelia M OBrien; Therese Dowswell; Andrea R Deussen
Journal:  Cochrane Database Syst Rev       Date:  2017-10-31

Review 2.  What we have learned about the role of 17-alpha-hydroxyprogesterone caproate in the prevention of preterm birth.

Authors:  Steve N Caritis; Maisa N Feghali; William A Grobman; Dwight J Rouse
Journal:  Semin Perinatol       Date:  2016-04-19       Impact factor: 3.300

Review 3.  Prevention of preterm delivery with 17-hydroxyprogesterone caproate: pharmacologic considerations.

Authors:  Maisa Feghali; Raman Venkataramanan; Steve Caritis
Journal:  Semin Perinatol       Date:  2014-09-23       Impact factor: 3.300

4.  Progesterone supplementation and the prevention of preterm birth.

Authors:  Errol R Norwitz; Aaron B Caughey
Journal:  Rev Obstet Gynecol       Date:  2011

5.  Progesterone to prevent preterm birth in twin gestations: what is the next step forward?

Authors:  R Romero
Journal:  BJOG       Date:  2013-01       Impact factor: 6.531

6.  Pharmacokinetics of 17-hydroxyprogesterone caproate in multifetal gestation.

Authors:  Steve N Caritis; Shringi Sharma; Raman Venkataramanan; Dwight J Rouse; Alan M Peaceman; Anthony Sciscione; Catherine Y Spong; Michael W Varner; Fergal D Malone; Jay D Iams; Brian M Mercer; John M Thorp; Yoram Sorokin; Marshall Carpenter; Julie Lo; Susan Ramin; Margaret Harper
Journal:  Am J Obstet Gynecol       Date:  2011-03-22       Impact factor: 8.661

7.  Expression of gastrin-releasing peptide is increased by prolonged stretch of human myometrium, and antagonists of its receptor inhibit contractility.

Authors:  Mark Tattersall; Yolande Cordeaux; D Stephen Charnock-Jones; Gordon C S Smith
Journal:  J Physiol       Date:  2012-03-12       Impact factor: 5.182

Review 8.  Preterm birth.

Authors:  David M Haas
Journal:  BMJ Clin Evid       Date:  2011-04-04

Review 9.  What we have learned about the design of randomized trials in pregnancy.

Authors:  Elizabeth A Thom; Madeline Murguia Rice; George R Saade; Uma M Reddy
Journal:  Semin Perinatol       Date:  2016-06-22       Impact factor: 3.300

10.  Pharmacology and placental transport of 17-hydroxyprogesterone caproate in singleton gestation.

Authors:  Steve N Caritis; Shringi Sharma; Raman Venkataramanan; Gary D Hankins; Menachem Miodovnik; Mary F Hebert; Jason G Umans; Thomas Benedetti; Donald Mattison; Anne Zajicek; Dawn Fischer; Aimee Jackson
Journal:  Am J Obstet Gynecol       Date:  2012-08-16       Impact factor: 8.661

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