Rates of recurrent preterm birth by maternal body habitus in women receiving 17alpha-hydroxyprogesterone caproate.
- 2013
Available online through MWHC library: 2013 to the present
CONCLUSIONS: Recurrent spontaneous preterm delivery<37 weeks in patients on 17P is more common in lean women (BMI<18.5kg/m(2)), and less common in obese women (BMI >30kg/m(2)) suggesting that the current recommended dosing of 17P is adequate for women with higher BMI. METHODS: Retrospective analysis of a cohort of 6253 women with a singleton gestation and prior SPTB enrolled in 17P home administration program between 16.0 and 26.9 weeks. Data were grouped by pre-pregnancy BMI (lean <18.5kg/m(2), normal 18.5-24.9kg/m(2), overweight 25-29.9kg/m(2) and obese >30.0kg/m(2)). Delivery outcomes were compared using chi(2) and Kruskal-Wallis tests with statistical significance set at p<0.05. OBJECTIVE: To examine the influence of maternal pre-pregnancy body mass index (BMI) on the rates of recurrent spontaneous preterm birth (SPTB) in women receiving 17alpha-hydroxyprogesterone caproate (17P). RESULTS: SPTB<28 weeks was significantly lower in normal weight women. Rates of recurrent SPTB<37 weeks were highest in the group with BMI<18.5kg/m(2). Lean gravidas were younger, more likely to smoke, and less likely to be African-American than those with normal or increased BMI. In logistic regression, after controlling for race and prior preterm birth <28 weeks, the risk of SPTB<37 weeks decreased 2% for every additional 1kg/m(2) increase in BMI.