Rittenberg Charles, Sullivan Scott, Istwan Niki, Rhea Debbie, Stanziano Gary, Newman Roger
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA.
Am J Obstet Gynecol. 2007 Sep;197(3):262.e1-4. doi: 10.1016/j.ajog.2007.06.032.
The objective of the study was to describe clinical characteristics and pregnancy outcomes of women in a community setting prescribed 17 alpha-hydroxyprogesterone caproate (17P) prophylaxis for prevention of preterm delivery (PTD).
A retrospective review was conducted of data collected from patients enrolled for weekly outpatient 17P administration and nursing assessment between April 2004 and January 1, 2006 (n = 1979). Pregnancy history, referral indication, labor/delivery onset (spontaneous or indicated), and gestational duration were identified.
Almost 80% of women prescribed 17P had a prior preterm delivery, although only 711 of the study population (35.9%) met National Institute of Child Health and Human Development (NICHD) study criteria for 17P including initiation of treatment at 16 to 20.9 weeks. Spontaneous PTD occurred in 37.3%; 22.1% delivered less than 35 weeks; and 9.0% less than 32 weeks. More than one quarter of patients (26.9%) discontinued 17P at less than 34 weeks and prior to delivery.
In community practice, only one third of patients receiving 17P met strict NICHD study criteria. Early initiation and adherence to completion of therapy are clinical issues related to 17P prophylaxis.
本研究的目的是描述在社区环境中接受己酸17α-羟孕酮（17P）预防早产（PTD）的女性的临床特征和妊娠结局。
对2004年4月至2006年1月1日期间每周接受门诊17P给药和护理评估的患者（n = 1979）收集的数据进行回顾性分析。确定妊娠史、转诊指征、分娩/发动（自发或指征性）和孕周。
接受17P治疗的女性中近80%既往有早产史，尽管研究人群中只有711人（35.9%）符合美国国立儿童健康与人类发展研究所（NICHD）17P研究标准，包括在16至20.9周开始治疗。自发早产发生率为37.3%；22.1%在35周前分娩；9.0%在32周前分娩。超过四分之一的患者（26.9%）在34周前且在分娩前停用了17P。
在社区实践中，接受17P治疗的患者中只有三分之一符合严格的NICHD研究标准。早期开始治疗并坚持完成治疗是与17P预防相关的临床问题。
