Rittenberg Charles, Sullivan Scott, Istwan Niki, Rhea Debbie, Stanziano Gary, Newman Roger
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
Am J Obstet Gynecol. 2008 Oct;199(4):389.e1-4. doi: 10.1016/j.ajog.2008.06.070.
The objective of the study was to compare pregnancy outcomes of women receiving 17-alpha-hydroxyprogesterone caproate (17P) prophylaxis for the prevention of recurrent spontaneous preterm delivery (SPTD) hospitalized for preterm labor (PTL) less than 34 weeks' gestation prescribed daily vs weekly perinatal nursing surveillance.
Singleton gestations with prior SPTD enrolled for outpatient 17P administration at less than 27 weeks' gestation were eligible. Women hospitalized for PTL at less than 34 weeks (n = 379) were identified. Women receiving daily perinatal nursing surveillance (dPNS) (n = 99) following PTL were matched by Medicaid status and gestational age at onset of PTL to women receiving weekly surveillance (n = 280), yielding 83 matched pairs.
Among patients receiving 17P who were hospitalized for PTL, the addition of dPNS following hospitalization resulted in lower rates of SPTD less than 32 weeks (odds ratio [OR], 0.29, 95% confidence interval [CI], 0.21-0.38) and less than 35 weeks (OR, 0.25, 95% CI, 0.17-0.33), whereas the rates of SPTD less than 37 weeks were similar.
Women receiving prophylactic 17P hospitalized for PTL before 34 weeks benefit from the addition of daily perinatal nursing surveillance.
本研究的目的是比较接受己酸17-α-羟孕酮（17P）预防复发性自发性早产（SPTD）的孕妇的妊娠结局，这些孕妇因妊娠小于34周的早产（PTL）住院，根据围产期护理监测情况每日或每周给药。
纳入妊娠小于27周时登记门诊接受17P治疗的既往有SPTD的单胎妊娠者。确定妊娠小于34周因PTL住院的妇女（n = 379）。根据医疗补助状态和PTL发作时的孕周，将PTL后接受每日围产期护理监测（dPNS）的妇女（n = 99）与接受每周监测的妇女（n = 280）进行匹配，得到83对匹配组。
在因PTL住院且接受17P治疗的患者中，住院后增加dPNS可降低小于32周（比值比[OR]，0.29，95%置信区间[CI]，0.21 - 0.38）和小于35周（OR，0.25，95% CI，0.17 - 0.33）的SPTD发生率，而小于37周的SPTD发生率相似。
妊娠小于34周因PTL住院且接受预防性17P治疗的妇女，增加每日围产期护理监测有益。
