Abstract
We read with the great interest the article by Ning et al. titled ‘Gestational age at initiation of 17-alpha hydroxyprogesterone caproate and recurrent preterm birth’ [ [1] Ning A. Vladutiu C.J. Dotters-Katz S.K. et al. Gestational age at initiation of 17-alpha hydroxyprogesterone caproate and recurrent preterm birth. Am J Obstet Gynecol. 2017; 217: 371.e1 Google Scholar ]. The authors reported a significant effect of 17-hydroxyprogesterone caproate (17-OHPC) among women with a prior spontaneous preterm birth (PTB), and suggested that the initiation of 17-OHPC should be facilitated at 16 weeks as far as possible. Women with early 17-OHPC initiation tended to deliver later. However, Caritis et al. reported that the effectiveness of 17-OHPC for recurrent PTB was associated with maternal weight and/or body mass index (BMI) [ [2] Caritis S.N. Sharma S. Venkataramanan R. Pharmacokinetics of 17-hydroxyprogesterone caproate in multifetal gestation. Am J Obstet Gynecol. 2011; 205: 40.e1 Google Scholar ]. Previous studies showed that the effectiveness of 17-OHPC was inversely associated with weight and BMI; as such, 17-OHPC administration could not decrease the rate of PTB in women who were obese or whose weight was > 165 lbs [ [3] Heyborne K.D. Allshouse A.A. Carey J.C. Does 17-alpha hydroxyprogesterone caproate prevent recurrent preterm birth in obese women?. Am J Obstet Gynecol. 2015; 213: 844.e1 Google Scholar ]. Based on these findings, we believe that weight or BMI should be considered more comprehensively before the initiation of 17-OHPC among women with a prior spontaneous PTB.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call