Clinical characteristics of women prescribed 17 alpha-hydroxyprogesterone caproate in the community setting.

Objective: The objective of the study was to describe clinical characteristics and pregnancy outcomes of women in a community setting prescribed 17 alpha-hydroxyprogesterone caproate (17P) prophylaxis for prevention of preterm delivery (PTD).

Study Design: A retrospective review was conducted of data collected from patients enrolled for weekly outpatient 17P administration and nursing assessment between April 2004 and January 1, 2006 (n = 1979). Pregnancy history, referral indication, labor/delivery onset (spontaneous or indicated), and gestational duration were identified.

Results: Almost 80% of women prescribed 17P had a prior preterm delivery, although only 711 of the study population (35.9%) met National Institute of Child Health and Human Development (NICHD) study criteria for 17P including initiation of treatment at 16 to 20.9 weeks. Spontaneous PTD occurred in 37.3%; 22.1% delivered less than 35 weeks; and 9.0% less than 32 weeks. More than one quarter of patients (26.9%) discontinued 17P at less than 34 weeks and prior to delivery.

Conclusion: In community practice, only one third of patients receiving 17P met strict NICHD study criteria. Early initiation and adherence to completion of therapy are clinical issues related to 17P prophylaxis.