Meta-analysis of randomized controlled trials comparing 17α-hydroxyprogesterone caproate and vaginal progesterone for the prevention of recurrent spontaneous preterm delivery

Elizabeth Oler, Ahizechukwu Eke, Ashley Hesson

Research output: Contribution to journalReview article

Abstract

Background: Vaginal progesterone and 17α-hydroxyprogesterone (17α-OHP) are both used to prevent preterm delivery in women who have experienced spontaneous preterm delivery (SPTD) previously. Randomized trial data of the comparative effectiveness of these interventions have been mixed. Objectives: To compare the efficacy of intramuscular 17α-OHP and vaginal progesterone in the prevention of recurrent SPTD. Search strategy: Cochrane Central Register of Controlled Trials, African Journals Online, Embase, Google Scholar, ISI Web of Science, LILACS, CINAHL, PubMed, and registers of ongoing trials were searched using keywords related to 17α-OHP, vaginal progesterone, and preterm delivery. Selection criteria: Randomized controlled trials published between January 1, 1966, and November 30, 2016, comparing 17α-OHP and vaginal progesterone for the prevention of recurrent SPTD during singleton pregnancies were included. Data collection and analysis: Study data were extracted and meta-analyses were performed when outcomes were comparable. Main results: The meta-analyses included data from three randomized trials. Lower rates of SPTD before 34 weeks (relative risk 0.71, 95% confidence interval 0.53–0.95) and before 32 weeks (relative risk 0.62, 95% confidence interval 0.40–0.94) of pregnancy were observed among patients treated with vaginal progesterone. Conclusions: Vaginal progesterone and 17α-OHP were comparable for the prevention of recurrent SPTD in singleton pregnancies; vaginal progesterone could be superior.

Original languageEnglish (US)
Pages (from-to)12-16
Number of pages5
JournalInternational Journal of Gynecology and Obstetrics
Volume138
Issue number1
DOIs
StatePublished - Jul 1 2017

Fingerprint

17-alpha-Hydroxyprogesterone
Progesterone
Meta-Analysis
Randomized Controlled Trials
Pregnancy
Confidence Intervals
17-alpha-hydroxy-progesterone caproate
PubMed
Patient Selection

Keywords

  • 17 alpha progesterone
  • Preterm labor
  • Recurrent preterm delivery
  • Vaginal progesterone

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

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title = "Meta-analysis of randomized controlled trials comparing 17α-hydroxyprogesterone caproate and vaginal progesterone for the prevention of recurrent spontaneous preterm delivery",
abstract = "Background: Vaginal progesterone and 17α-hydroxyprogesterone (17α-OHP) are both used to prevent preterm delivery in women who have experienced spontaneous preterm delivery (SPTD) previously. Randomized trial data of the comparative effectiveness of these interventions have been mixed. Objectives: To compare the efficacy of intramuscular 17α-OHP and vaginal progesterone in the prevention of recurrent SPTD. Search strategy: Cochrane Central Register of Controlled Trials, African Journals Online, Embase, Google Scholar, ISI Web of Science, LILACS, CINAHL, PubMed, and registers of ongoing trials were searched using keywords related to 17α-OHP, vaginal progesterone, and preterm delivery. Selection criteria: Randomized controlled trials published between January 1, 1966, and November 30, 2016, comparing 17α-OHP and vaginal progesterone for the prevention of recurrent SPTD during singleton pregnancies were included. Data collection and analysis: Study data were extracted and meta-analyses were performed when outcomes were comparable. Main results: The meta-analyses included data from three randomized trials. Lower rates of SPTD before 34 weeks (relative risk 0.71, 95{\%} confidence interval 0.53–0.95) and before 32 weeks (relative risk 0.62, 95{\%} confidence interval 0.40–0.94) of pregnancy were observed among patients treated with vaginal progesterone. Conclusions: Vaginal progesterone and 17α-OHP were comparable for the prevention of recurrent SPTD in singleton pregnancies; vaginal progesterone could be superior.",
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N2 - Background: Vaginal progesterone and 17α-hydroxyprogesterone (17α-OHP) are both used to prevent preterm delivery in women who have experienced spontaneous preterm delivery (SPTD) previously. Randomized trial data of the comparative effectiveness of these interventions have been mixed. Objectives: To compare the efficacy of intramuscular 17α-OHP and vaginal progesterone in the prevention of recurrent SPTD. Search strategy: Cochrane Central Register of Controlled Trials, African Journals Online, Embase, Google Scholar, ISI Web of Science, LILACS, CINAHL, PubMed, and registers of ongoing trials were searched using keywords related to 17α-OHP, vaginal progesterone, and preterm delivery. Selection criteria: Randomized controlled trials published between January 1, 1966, and November 30, 2016, comparing 17α-OHP and vaginal progesterone for the prevention of recurrent SPTD during singleton pregnancies were included. Data collection and analysis: Study data were extracted and meta-analyses were performed when outcomes were comparable. Main results: The meta-analyses included data from three randomized trials. Lower rates of SPTD before 34 weeks (relative risk 0.71, 95% confidence interval 0.53–0.95) and before 32 weeks (relative risk 0.62, 95% confidence interval 0.40–0.94) of pregnancy were observed among patients treated with vaginal progesterone. Conclusions: Vaginal progesterone and 17α-OHP were comparable for the prevention of recurrent SPTD in singleton pregnancies; vaginal progesterone could be superior.

AB - Background: Vaginal progesterone and 17α-hydroxyprogesterone (17α-OHP) are both used to prevent preterm delivery in women who have experienced spontaneous preterm delivery (SPTD) previously. Randomized trial data of the comparative effectiveness of these interventions have been mixed. Objectives: To compare the efficacy of intramuscular 17α-OHP and vaginal progesterone in the prevention of recurrent SPTD. Search strategy: Cochrane Central Register of Controlled Trials, African Journals Online, Embase, Google Scholar, ISI Web of Science, LILACS, CINAHL, PubMed, and registers of ongoing trials were searched using keywords related to 17α-OHP, vaginal progesterone, and preterm delivery. Selection criteria: Randomized controlled trials published between January 1, 1966, and November 30, 2016, comparing 17α-OHP and vaginal progesterone for the prevention of recurrent SPTD during singleton pregnancies were included. Data collection and analysis: Study data were extracted and meta-analyses were performed when outcomes were comparable. Main results: The meta-analyses included data from three randomized trials. Lower rates of SPTD before 34 weeks (relative risk 0.71, 95% confidence interval 0.53–0.95) and before 32 weeks (relative risk 0.62, 95% confidence interval 0.40–0.94) of pregnancy were observed among patients treated with vaginal progesterone. Conclusions: Vaginal progesterone and 17α-OHP were comparable for the prevention of recurrent SPTD in singleton pregnancies; vaginal progesterone could be superior.

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