Julia Timofeev1, Jasbir Singh1, Niki Istwan2, Debbie Rhea2, Rita W Driggers1. 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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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 outpatient17P 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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Amy L Turitz; Jamie A Bastek; Stephanie E Purisch; Michal A Elovitz; Lisa D Levine Journal: Am J Obstet Gynecol Date: 2015-10-28 Impact factor: 8.661
Authors: Tracy A Manuck; Lisa Smeester; Elizabeth M Martin; Martha S Tomlinson; Christina Smith; Michael W Varner; Rebecca C Fry Journal: Am J Perinatol Date: 2017-12-14 Impact factor: 1.862