Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
Department of Clinical Research, Alere Health, Women's and Children's Health, Atlanta, Georgia.
Am J Perinatol. 2014 Jan;31(1):55-60. doi: 10.1055/s-0033-1334452. Epub 2013 Mar 1.
To determine if the rates of recurrent spontaneous preterm birth in women receiving 17α-hydroxyprogesterone caproate (17P) differ according to maternal race.
Retrospective analysis of a cohort of women enrolled in outpatient 17P administration at < 27 weeks. Maternal characteristics, obstetric history, and rates of recurrent preterm birth were determined using chi-square and multivariable Cox proportional hazards regression at two-tailed α = 0.05. Primary study outcome was defined as having a spontaneous preterm birth < 34 weeks.
African-American women initiated 17P injections later (19.6 versus 18.9 weeks, p < 0.001) and discontinued injections earlier (33.2 versus 34.1 weeks, p < 0.001) than Caucasian women. Spontaneous recurrent preterm birth < 34 weeks was higher in African-Americans versus Caucasians receiving 17P (odds ratio 2.1; 95% confidence interval 1.7, 2.4). After adjusting for other significant factors, African-American race retained the strongest association with recurrent spontaneous preterm birth < 34 weeks. Within each racial group, short cervical length < 25 mm before 27 weeks' gestation had the highest hazard of recurrent spontaneous preterm delivery.
Despite treatment with 17P, African-American women have higher rates of recurrent preterm birth.
确定接受 17α-羟孕酮己酸酯（17P）治疗的女性中，复发性自发性早产的发生率是否因母体种族而异。
对在 < 27 周接受门诊 17P 给药的女性队列进行回顾性分析。使用卡方检验和多变量 Cox 比例风险回归分析确定母体特征、产科史和复发性早产率，双侧 α 值为 0.05。主要研究结果定义为自发性早产 < 34 周。
与高加索女性相比，非裔美国女性开始接受 17P 注射的时间较晚（19.6 周比 18.9 周，p<0.001），停止注射的时间较早（33.2 周比 34.1 周，p<0.001）。与接受 17P 治疗的高加索女性相比，非裔美国女性的自发性复发性早产 < 34 周的发生率更高（比值比 2.1；95%置信区间 1.7，2.4）。在调整其他重要因素后，非裔美国人的种族与复发性自发性早产 < 34 周仍保持最强的关联。在每个种族群体中，妊娠 27 周前宫颈长度 < 25 mm 与复发性自发性早产的风险最高。
尽管接受了 17P 治疗，非裔美国女性的复发性早产率仍较高。
