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

Problem 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. Methods of study This was a retrospective cohort study. One hundred and seven PTL...

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Published in:American journal of reproductive immunology (1989) 2018-09, Vol.80 (3), p.e12867-n/a
Main Authors: Yoneda, Satoshi, Yoneda, Noriko, Shiozaki, Arihiro, Yoshino, Osamu, Ueno, Tomohiro, Niimi, Hideki, Kitajima, Isao, Tamura, Kentaro, Kawasaki, Yukako, Makimoto, Masami, Yoshida, Taketoshi, Saito, Shigeru
Format: Article
Language:English
Subjects:
17OHP‐C
amniotic fluid IL‐8
Inflammation
intra‐amniotic microbes
Patients
preterm labor
sterile intra‐amniotic inflammation
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Summary:Problem 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. Methods of study 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. Results 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. Conclusion 17OHP‐C could prolong gestational period in limited PTL cases with sterile mild intra‐amniotic inflammation.
ISSN:1046-7408
1600-0897
DOI:10.1111/aji.12867