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

Spontaneous preterm birth in African-American and Caucasian women receiving 17alpha-hydroxyprogesterone caproate. - 2014

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 17alpha-hydroxyprogesterone caproate (17P) differ according to maternal race. 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<25mm before 27 weeks' gestation had the highest hazard of recurrent spontaneous preterm delivery. 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 alpha=0.05. Primary study outcome was defined as having a spontaneous preterm birth<34 weeks.


English

0735-1631


*African Americans/sn [Statistics & Numerical Data]
*Estradiol Antagonists/tu [Therapeutic Use]
*European Continental Ancestry Group/sn [Statistics & Numerical Data]
*Hydroxyprogesterones/tu [Therapeutic Use]
*Premature Birth/eh [Ethnology]
*Premature Birth/pc [Prevention & Control]
Adolescent
Adult
Cervical Length Measurement
Cervix Uteri/ah [Anatomy & Histology]
Female
Gestational Age
Humans
Pregnancy
Pregnancy, High-Risk
Recurrence/pc [Prevention & Control]
Retrospective Studies
Young Adult


MedStar Washington Hospital Center


Obstetrics and Gynecology/Maternal-Fetal Medicine


Journal Article

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