17OHP-C in patients with spontaneous preterm labor and intact membranes: is there an effect according to the presence of intra-amniotic inflammation?

Abstract

It is not known whether 17-alpha-hydroxyprogesterone caproate (17OHP-C) is effective for preventing preterm delivery with an episode of preterm labor (PTL) with or without intra-amniotic inflammation/infection. This was a retrospective cohort study. One hundred and seven PTL patients were selected and divided into a 17OHP-C group (use of 17OHP-C: n=53) and a no-treatment group (no use of 17OHP-C: n=54). Moreover, the patients were divided into three subgroups (subgroup A: without intra-amniotic inflammation, B: with mild intra-amniotic inflammation, and C: with severe intra-amniotic inflammation) according to their level of amniotic interleukin (IL)-8, and perinatal prognosis was analyzed. Interval from admission to delivery (days) in the 17OHP-C group (76 [13-126], n=34) was significantly longer than that in the no-treatment group (50 [8-104], n=33; P=.012) in subgroup B. In cases without intra-amniotic microbes in subgroup B, a significant prolongation of gestational days was associated with the 17OHP-C group (79 [13-126], n=25) compared with the no-treatment group (50 [8-104], n=29; P=.029). However, there were no significant differences in subgroups A or C. 17OHP-C could prolong gestational period in limited PTL cases with sterile mild intra-amniotic inflammation.