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A portion of this study was sponsored by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001105. Additionally, members of this research team (Drs Nelson, McIntire, and Leveno) were supported by the Parkland Hospital Obstetric Research Center.
The authors report no conflict of interest.
Cite this article as: Nelson DB, McIntire DD, McDonald J, et al. 17-alpha Hydroxyprogesterone caproate did not reduce the rate of recurrent preterm birth in a prospective cohort study. Am J Obstet Gynecol 2017;216:600.e1-9.
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- ReplyAmerican Journal of Obstetrics & GynecologyVol. 218Issue 2
- Do maternal obesity or smoking explain the lack of effectiveness of 17-alpha hydroxyprogesterone caproate?American Journal of Obstetrics & GynecologyVol. 217Issue 5
- PreviewWe thank Nelson et al1 for their recent study showing lack of efficacy of 17-alpha hydroxyprogesterone caproate (17OHP-C) for the prevention of recurrent preterm birth in their population. The adoption of 17OHP-C into widespread clinical practice based primarily on a single trial2 is somewhat unusual, and further validation is certainly warranted. Like these authors, we anxiously await the results of the PROLONG trial.
- ReplyAmerican Journal of Obstetrics & GynecologyVol. 217Issue 5
- PreviewDrs Heyborne and Allshouse have written regarding our recent publication1 in which we describe the ineffectiveness of 17-alpha hydroxyprogesterone caproate (17OHP-C) to prevent recurrent preterm birth. These investigators previously hypothesized, using secondary analysis of the Maternal-Fetal Medicine Units Network trial by Meis et al,2 that maternal smoking increased the effectiveness of 17OHP-C whereas larger maternal habitus decreased effectiveness.3,4
- Response to 17-alpha hydroxyprogesterone caproateAmerican Journal of Obstetrics & GynecologyVol. 219Issue 2
- ReplyAmerican Journal of Obstetrics & GynecologyVol. 218Issue 3
- ReplyAmerican Journal of Obstetrics & GynecologyVol. 219Issue 2
- PreviewDr Vadnais and Ms Frappaolo ask an important question. They ask that because professional organizations, such as the Society for Maternal-Fetal Medicine (SMFM), have legitimized the use of 17-alpha hydroxyprogesterone caproate (17OHP-C) for prevention of recurrent preterm birth, what is a provider to do given the published results of our study? This question is timely given the recent US Food and Drug Administration approval of the Makena auto-injector (AMAG Pharmaceuticals, 2018).1
- Clinical trials and tribulations: 17OHPC and preventing recurrent preterm birthAmerican Journal of Obstetrics & GynecologyVol. 216Issue 6
- PreviewIn this issue of the Journal, Nelson et al1 report a prospective cohort of 430 consecutive women pregnant with a single fetus who had a history of 1 or more prior singleton spontaneous preterm births (ssPTBs). The women all received intramuscular(IM) 17-alpha hydroxyprogesterone caproate (17OHPC) prophylaxis without a lowering in the preterm birth (PTB) recurrence rate. The investigators were surprised by this in light of the specific recommendation of the Society of Maternal-Fetal Medicine (SMFM)2 for use of 17OHPC for this indication, first in 2012, but just reaffirmed3 in 2017.