Department of Obstetrics and Gynecology, Central Baptist Hospital, Lexington, KY, USA.
Am J Obstet Gynecol. 2011 Sep;205(3):269.e1-6. doi: 10.1016/j.ajog.2011.06.039. Epub 2011 Jun 17.
The purpose of this study was to determine the role of previous term delivery on the rate of recurrent preterm birth in women with previous spontaneous preterm delivery (SPTD) who receive 17-alphahydroxyprogesterone caproate (17P) therapy.
Women with singleton gestations who were receiving 17P therapy were studied. Rates of recurrent SPTD were compared for 1 or ≥2 SPTD with and without a previous term delivery.
Five thousand one hundred two women had 1 previous SPTD, and 2217 women had ≥2 SPTDs. In women with 1 previous SPTD, a previous term delivery had lower rates of SPTD at <35 weeks (8.4% vs 11.2%; P = .002) and preterm delivery at <32 weeks (4.7% vs 6.2%; P = .027) compared with those women with no such history. No differences were found for SPTD at <35 weeks with ≥2 SPTDs.
In patients who received 17P therapy with 1 previous SPTD, a previous term delivery confers a reduction in risk of preterm delivery at <37, <35, and <32 weeks' gestation; such reduction is not evident with ≥2 previous SPTDs.
本研究旨在确定对于接受 17α-羟孕酮己酸酯（17P）治疗且既往有自发性早产（SPT）史的女性，既往足月分娩对复发性早产的发生率的影响。
研究了接受 17P 治疗的单胎妊娠女性。比较了 1 次及≥2 次 SPTD 且有无既往足月分娩的复发性 SPTD 发生率。
5102 名女性有 1 次既往 SPTD，2217 名女性有≥2 次 SPTD。在既往有 1 次 SPTD 的女性中，与无此病史的女性相比，有既往足月分娩史的女性其妊娠 35 周前的 SPTD 发生率（8.4%比 11.2%；P=0.002）和妊娠 32 周前的早产发生率（4.7%比 6.2%；P=0.027）更低。对于≥2 次 SPTD，妊娠 35 周前的 SPTD 发生率无差异。
在接受 17P 治疗且既往有 1 次 SPTD 的患者中，既往足月分娩可降低妊娠 37 周、35 周和 32 周前早产的风险；但对于≥2 次既往 SPTD 则无明显影响。
