Spontaneous preterm birth in African-American and Caucasian women receiving 17alpha-hydroxyprogesterone caproate.
Citation: American Journal of Perinatology. 31(1):55-60, 2014 Jan.PMID: 23456908Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 AdultYear: 2014ISSN:- 0735-1631
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 23456908 | Available | 23456908 |
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.
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