Recurrent Preterm Delivery in Women Receiving 17-P is Not Influenced by Prior Spontaneous Preterm Delivery Etiology [8Q

Abstract

INTRODUCTION: To compare rates of recurrent preterm delivery (PTD) in women receiving 17-P therapy for prior spontaneous PTD (sPTD) due to either Preterm Premature Rupture of Membranes (PPROM) or preterm labor (PTL). METHODS: Study sample derived from a national database of women receiving 17-P therapy as part of a PTD prevention program. Inclusion criteria: women meeting SMFM criteria recommendations for 17-P administration, documented history of prior sPTD, singleton gestation and receiving at least 4 weekly 17-P injections. Demographic and clinical risk factors for PTD as well as pregnancy outcomes were compared between those with prior history of sPTD with PTL vs PPROM. Rank and chi-square tests were used to compare study groups, with P-values < .05 considered statistically significant. RESULTS: 2,084 women with prior sPTD were studied: 450 with prior PPROM, 1,634 with prior PTL. There were no significant differences between prior PPROM vs prior PTL study groups for race, ethnicity and pre-pregnancy BMI < 20 or >30. The number of previous PTDs (1.3 ± 0.6 vs 1.3 ± 0.6), gestational age of the most recent PTD (31.8 ± 4.6 vs 31.5 ± 4.5 weeks) and the total number of 17-P injections (18.7 ± 2.4 versus 18.9 ± 2.3) were also similar. Overall, with 17-P therapy, there were no significant differences between study groups for PTD at < 37.0, < 35.0 and < 32.0 weeks or sPTD < 37.0 weeks. CONCLUSION: In women receiving 17-P therapy, recurrent PTD and sPTD rates are not affected by the etiology of the prior sPTD.