己酸17α-羟孕酮预防复发性早产：治疗开始时的孕周是否重要？
Prophylaxis with 17 alpha-hydroxyprogesterone caproate for prevention of recurrent preterm delivery: does gestational age at initiation of treatment matter?
作者信息
How Helen Y, Barton John R, Istwan Niki B, Rhea Debbie J, Stanziano Gary J
机构信息
Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, OH, USA.
出版信息
Am J Obstet Gynecol. 2007 Sep;197(3):260.e1-4. doi: 10.1016/j.ajog.2007.07.013.
OBJECTIVE
The purpose of this study was to determine effectiveness of 17 alpha-hydroxyprogesterone caproate (17 P) prophylaxis by gestational age (GA) at 17 P initiation.
STUDY DESIGN
Singleton gestations with > or = 1 preterm birth (PTB) treated with 17 P prophylaxis for recurrent preterm birth before 27 weeks were identified from a data base. Data were stratified by GA at 17 P initiation (16-20.9 [n = 599] weeks and 21-26.9 [n = 307] weeks) and number of PTB (1, 2, > 2). Outcome variables were PTB at < 37, < 35, and < 32 weeks.
RESULTS
No significant differences were found in gestational age at delivery or rates of recurrent PTB < 37, < 35, and < 32 weeks between those women initiating 17 P at 16-20.9 weeks or 21-26.9 weeks, or when stratified by number of prior preterm deliveries.
CONCLUSION
Initiation of 17 P prophylaxis at 21-26.9 weeks is as effective as initiation at 16-20.9 weeks of gestation.
目的
本研究旨在确定在开始使用己酸17α-羟孕酮（17P）时，按孕周（GA）进行17P预防的有效性。
研究设计
从一个数据库中识别出单胎妊娠且有≥1次早产（PTB），在27周前接受17P预防复发性早产治疗的病例。数据按开始使用17P时的孕周（16 - 20.9周[n = 599]和21 - 26.9周[n = 307]）以及早产次数（1次、2次、>2次）进行分层。观察指标为孕周<37周、<35周和<32周时的早产情况。
结果
在16 - 20.9周或21 - 26.9周开始使用17P的女性，或按既往早产次数分层时，在分娩孕周或孕周<37周、<35周和<32周的复发性早产发生率方面未发现显著差异。
结论
在21 - 26.9周开始进行17P预防与在妊娠16 - 20.9周开始预防的效果相同。
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