17α-羟孕酮己酸酯预防宫颈长度小于 30mm 的初产妇早产。
17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30 mm.
机构信息
Northwestern University, Chicago, IL, USA.
出版信息
Am J Obstet Gynecol. 2012 Nov;207(5):390.e1-8. doi: 10.1016/j.ajog.2012.09.013. Epub 2012 Sep 17.
Abstract
OBJECTIVE
We sought to evaluate whether 17 alpha-hydroxyprogesterone caproate (17-OHP) reduces preterm birth (PTB) in nulliparous women with a midtrimester cervical length (CL) <30 mm.
STUDY DESIGN
In this multicenter randomized controlled trial, nulliparous women with a singleton gestation between 16 and 22 3/7 weeks with an endovaginal CL <30 mm (<10th percentile in this population) were randomized to weekly intramuscular 17-OHP (250 mg) or placebo through 36 weeks. The primary outcome was PTB <37 weeks.
RESULTS
The frequency of PTB did not differ between the 17-OHP (n = 327) and placebo (n = 330) groups (25.1% vs 24.2%; relative risk, 1.03; 95% confidence interval, 0.79-1.35). There also was no difference in the composite adverse neonatal outcome (7.0% vs 9.1%; relative risk, 0.77; 95% confidence interval, 0.46-1.30).
CONCLUSION
Weekly 17-OHP does not reduce the frequency of PTB in nulliparous women with a midtrimester CL <30 mm.
摘要
目的
我们旨在评估 17α-羟孕酮己酸酯（17-OHP）是否能降低中孕期宫颈长度（CL）<30mm 的初产妇的早产（PTB）发生率。
研究设计
在这项多中心随机对照试验中，将 16 至 22 3/7 周单胎妊娠且阴道内 CL<30mm（该人群中第 10 百分位数以下）的初产妇随机分为每周肌内注射 17-OHP（250mg）或安慰剂至 36 周。主要结局为<37 周的 PTB。
结果
17-OHP 组（n=327）和安慰剂组（n=330）的 PTB 发生率无差异（25.1% vs 24.2%；相对风险，1.03；95%置信区间，0.79-1.35）。复合不良新生儿结局（7.0% vs 9.1%；相对风险，0.77；95%置信区间，0.46-1.30）也无差异。
结论
每周使用 17-OHP 并不能降低中孕期 CL<30mm 的初产妇的 PTB 发生率。
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