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17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials

To perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) that investigated the clinical benefits of 17-alpha hydroxyprogesterone caproate (17OHPC) in the prevention of recurrent preterm birth (PTB) among singleton pregnant women with a previous history of PTB. We s...

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Autores principales: Baradwan, Saeed, Abdulghani, Sahar Hassan, Abuzaid, Mohammed, Khadawardi, Khalid, Alshahrani, Majed Saeed, Al-Matary, Abdulrahman, AlRasheed, May A., Miski, Najlaa Talat, Abdulhalim, Aroob, Alturki, Yousra Mansour, Abu-Zaid, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Obstetrics and Gynecology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595047/
https://www.ncbi.nlm.nih.gov/pubmed/34670064
http://dx.doi.org/10.5468/ogs.21264
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author Baradwan, Saeed
Abdulghani, Sahar Hassan
Abuzaid, Mohammed
Khadawardi, Khalid
Alshahrani, Majed Saeed
Al-Matary, Abdulrahman
AlRasheed, May A.
Miski, Najlaa Talat
Abdulhalim, Aroob
Alturki, Yousra Mansour
Abu-Zaid, Ahmed
author_facet Baradwan, Saeed
Abdulghani, Sahar Hassan
Abuzaid, Mohammed
Khadawardi, Khalid
Alshahrani, Majed Saeed
Al-Matary, Abdulrahman
AlRasheed, May A.
Miski, Najlaa Talat
Abdulhalim, Aroob
Alturki, Yousra Mansour
Abu-Zaid, Ahmed
author_sort Baradwan, Saeed
collection PubMed
description To perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) that investigated the clinical benefits of 17-alpha hydroxyprogesterone caproate (17OHPC) in the prevention of recurrent preterm birth (PTB) among singleton pregnant women with a previous history of PTB. We searched four major databases up till April 2021 and assessed the risk of bias in the included studies. We meta-analyzed various maternal-neonatal endpoints (n=18) and pooled them as mean difference or risk ratio (RR) with 95% confidence interval (CI) using the random-effects model. Six RCTs met the inclusion criteria, comprising 2,573 patients (17OHPC=1,617, control=956). RCTs revealed an overall low risk of bias. The rates of PTB <35 weeks (n=5 RCTs; RR, 0.77; 95% CI, 0.63–0.93; P=0.008), PTB <32 weeks (n=3 RCTs; RR, 0.68; 95% CI, 0.51–0.91; P=0.009), neonates with low birth weight (<2.5 kg) at delivery (n=3 RCTs; RR, 0.63; 95% CI, 0.5–0.79; P<0.001), and neonatal death (n=4 RCTs; RR, 0.41; 95% CI, 0.20–0.84; P=0.02) were significantly reduced in the 17OHPC group compared with the control group. Moreover, 17OHPC treatment correlated with a significantly decreased rate of retinopathy (n=2 RCTs; RR, 0.42; 95% CI, 0.18–0.97; P=0.004). However, there were no significant differences in the rates of neonatal intensive care unit admission, cesarean delivery, and other preterm-related complications between both the groups. Among singleton pregnant women with a prior history of PTB, 17OHPC may favorably decrease the risks of recurrent PTB and reduce the rate of neonatal death.
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spelling pubmed-85950472021-12-01 17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials Baradwan, Saeed Abdulghani, Sahar Hassan Abuzaid, Mohammed Khadawardi, Khalid Alshahrani, Majed Saeed Al-Matary, Abdulrahman AlRasheed, May A. Miski, Najlaa Talat Abdulhalim, Aroob Alturki, Yousra Mansour Abu-Zaid, Ahmed Obstet Gynecol Sci Review Article To perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) that investigated the clinical benefits of 17-alpha hydroxyprogesterone caproate (17OHPC) in the prevention of recurrent preterm birth (PTB) among singleton pregnant women with a previous history of PTB. We searched four major databases up till April 2021 and assessed the risk of bias in the included studies. We meta-analyzed various maternal-neonatal endpoints (n=18) and pooled them as mean difference or risk ratio (RR) with 95% confidence interval (CI) using the random-effects model. Six RCTs met the inclusion criteria, comprising 2,573 patients (17OHPC=1,617, control=956). RCTs revealed an overall low risk of bias. The rates of PTB <35 weeks (n=5 RCTs; RR, 0.77; 95% CI, 0.63–0.93; P=0.008), PTB <32 weeks (n=3 RCTs; RR, 0.68; 95% CI, 0.51–0.91; P=0.009), neonates with low birth weight (<2.5 kg) at delivery (n=3 RCTs; RR, 0.63; 95% CI, 0.5–0.79; P<0.001), and neonatal death (n=4 RCTs; RR, 0.41; 95% CI, 0.20–0.84; P=0.02) were significantly reduced in the 17OHPC group compared with the control group. Moreover, 17OHPC treatment correlated with a significantly decreased rate of retinopathy (n=2 RCTs; RR, 0.42; 95% CI, 0.18–0.97; P=0.004). However, there were no significant differences in the rates of neonatal intensive care unit admission, cesarean delivery, and other preterm-related complications between both the groups. Among singleton pregnant women with a prior history of PTB, 17OHPC may favorably decrease the risks of recurrent PTB and reduce the rate of neonatal death. Korean Society of Obstetrics and Gynecology 2021-11 2021-10-20 /pmc/articles/PMC8595047/ /pubmed/34670064 http://dx.doi.org/10.5468/ogs.21264 Text en Copyright © 2021 Korean Society of Obstetrics and Gynecology https://creativecommons.org/licenses/by-nc/3.0/Articles published in Obstet Gynecol Sci are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Baradwan, Saeed
Abdulghani, Sahar Hassan
Abuzaid, Mohammed
Khadawardi, Khalid
Alshahrani, Majed Saeed
Al-Matary, Abdulrahman
AlRasheed, May A.
Miski, Najlaa Talat
Abdulhalim, Aroob
Alturki, Yousra Mansour
Abu-Zaid, Ahmed
17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials
title 17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials
title_full 17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials
title_fullStr 17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials
title_full_unstemmed 17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials
title_short 17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials
title_sort 17-alpha hydroxyprogesterone caproate for the prevention of recurrent preterm birth among singleton pregnant women with a prior history of preterm birth: a systematic review and meta-analysis of six randomized controlled trials
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595047/
https://www.ncbi.nlm.nih.gov/pubmed/34670064
http://dx.doi.org/10.5468/ogs.21264
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