Trial reportAmerican journal of obstetrics and gynecology2014
Relationship between 17-alpha hydroxyprogesterone caproate concentration and spontaneous preterm birth.
Trial report in American journal of obstetrics and gynecology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies.The Cochrane database of systematic reviews · 2020Pooled it
- Omega-3 fatty acid addition during pregnancy.The Cochrane database of systematic reviews · 2018Pooled it
- 17-Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta-analysis.BJOG : an international journal of obstetrics and gynaecology · 2016Pooled it
- Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention.The New England journal of medicine · 2016Trial
- Smoking, 17 Alpha-Hydroxyprogesterone Caproate, and Preterm Birth.American journal of perinatology · 2016Trial
- Does 17-alpha hydroxyprogesterone caproate prevent recurrent preterm birth in obese women?American journal of obstetrics and gynecology · 2015Trial
- Vaginal administration of 17-alpha hydroxyprogesterone caproate appears to be safe in non-pregnant female rats and rabbits.Xenobiotica; the fate of foreign compounds in biological systems · 2024Article
- What now? A critical evaluation of over 20 years of clinical and research experience with 17-alpha hydroxyprogesterone caproate for recurrent preterm birth prevention.American journal of obstetrics & gynecology MFM · 2023Review
- Epigenetic Regulation of the Nitric Oxide Pathway, 17-α Hydroxyprogesterone Caproate, and Recurrent Preterm Birth.American journal of perinatology · 2018Article
- Controversies about the Secondary Prevention of Spontaneous Preterm Birth.Geburtshilfe und Frauenheilkunde · 2018Article
- Pharmacokinetics of Hydroxyprogesterone Caproate and its Primary Metabolites during Pregnancy.AJP reports · 2018Article
- Impact of Pregnancy History and 17-Hydroxyprogesterone Caproate on Cervical Cytokines and Matrix Metalloproteinases.American journal of perinatology · 2018Observational
- Vaginal progesterone to reduce preterm birth among HIV-infected pregnant women in Zambia: a feasibility study protocol.Pilot and feasibility studies · 2018Article
- The association among cytochrome P450 3A, progesterone receptor polymorphisms, plasma 17-alpha hydroxyprogesterone caproate concentrations, and spontaneous preterm birth.American journal of obstetrics and gynecology · 2017Article
- 17-alpha Hydroxyprogesterone caproate did not reduce the rate of recurrent preterm birth in a prospective cohort study.American journal of obstetrics and gynecology · 2017Article
- Population pharmacokinetics of 17α-hydroxyprogesterone caproate in singleton gestation.British journal of clinical pharmacology · 2016Article
- What we have learned about the role of 17-alpha-hydroxyprogesterone caproate in the prevention of preterm birth.Seminars in perinatology · 2016Review
- Pharmacogenomics of preterm birth prevention and treatment.BJOG : an international journal of obstetrics and gynaecology · 2016Review
- Route of administration and formulation dependent pharmacokinetics of 17-hydroxyprogesterone caproate in rats.Xenobiotica; the fate of foreign compounds in biological systems · 2016Article
- Basic obstetric pharmacology.Seminars in perinatology · 2014Review
Corrections and comments
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Authors and funding
17 authors at 14 institutions in 1 country.
Funding
Abstract
objective17-alpha hydroxyprogesterone caproate 250 mg weekly reduces recurrent spontaneous preterm birth in women with a prior spontaneous preterm birth by 33%. The dose is not based on pharmacologic considerations. A therapeutic concentration has not been determined hampering any attempt to optimize treatment. This study evaluated the relationship between 17-alpha hydroxyprogesterone caproate plasma concentrations and the rate of spontaneous preterm birth in women with singleton gestation. STUDY
designA single blood sample was obtained between 25 and 28 weeks' gestation from 315 women with a spontaneous preterm birth who participated in a placebo-controlled, prospective, randomized clinical trial evaluating the benefit of omega-3 supplementation in reducing preterm birth. All women in the parent study received 17-alpha hydroxyprogesterone caproate and 434 received omega-3 supplementation and 418 received a placebo. Plasma from 315 consenting women was analyzed for 17-alpha hydroxyprogesterone caproate concentration.
resultsThere were no differences between placebo and omega-3 supplemented groups in demographic variables, outcomes or in mean 17-alpha hydroxyprogesterone caproate concentration. Plasma concentrations of 17-alpha hydroxyprogesterone caproate ranged from 3.7-56 ng/mL. Women with plasma concentrations of 17-alpha hydroxyprogesterone caproate in the lowest quartile had a significantly higher risk of spontaneous preterm birth (P = .03) and delivered at significantly earlier gestational ages (P = .002) than did women in the second to fourth quartiles. The lowest preterm birth rates were seen when median 17-alpha hydroxyprogesterone caproate concentrations exceeded 6.4 ng/mL.
conclusionLow plasma 17-alpha hydroxyprogesterone caproate concentration is associated with an increased risk of spontaneous preterm birth. This finding validates efficacy of this treatment but suggests that additional studies are needed to determine the optimal dosage.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.