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:	Saeed Baradwan, Sahar Hassan Abdulghani, Mohammed Abuzaid, Khalid Khadawardi, Majed Saeed Alshahrani, Abdulrahman Al-Matary, May A. AlRasheed, Najlaa Talat Miski, Aroob Abdulhalim, Yousra Mansour Alturki, Ahmed Abu-Zaid
Formato:	article
Lenguaje:	EN KO
Publicado:	Korean Society of Obstetrics and Gynecology 2021
Materias:	17-alpha hydroxyprogesterone caproate pregnancy preterm birth premature birth Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/b5167d9351e5495eb8ff5f40cc4c85cb
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spelling	oai:doaj.org-article:b5167d9351e5495eb8ff5f40cc4c85cb2021-11-15T00:50:16Z17-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 trials2287-85722287-858010.5468/ogs.21264https://doaj.org/article/b5167d9351e5495eb8ff5f40cc4c85cb2021-11-01T00:00:00Zhttp://www.ogscience.org/upload/pdf/ogs-21264.pdfhttps://doaj.org/toc/2287-8572https://doaj.org/toc/2287-8580To 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.Saeed BaradwanSahar Hassan AbdulghaniMohammed AbuzaidKhalid KhadawardiMajed Saeed AlshahraniAbdulrahman Al-MataryMay A. AlRasheedNajlaa Talat MiskiAroob AbdulhalimYousra Mansour AlturkiAhmed Abu-ZaidKorean Society of Obstetrics and Gynecologyarticle17-alpha hydroxyprogesterone caproatepregnancypreterm birthpremature birthGynecology and obstetricsRG1-991ENKOObstetrics & Gynecology Science, Vol 64, Iss 6, Pp 484-495 (2021)
institution	DOAJ
collection	DOAJ
language	EN KO
topic	17-alpha hydroxyprogesterone caproate pregnancy preterm birth premature birth Gynecology and obstetrics RG1-991
spellingShingle	17-alpha hydroxyprogesterone caproate pregnancy preterm birth premature birth Gynecology and obstetrics RG1-991 Saeed Baradwan Sahar Hassan Abdulghani Mohammed Abuzaid Khalid Khadawardi Majed Saeed Alshahrani Abdulrahman Al-Matary May A. AlRasheed Najlaa Talat Miski Aroob Abdulhalim Yousra Mansour Alturki Ahmed Abu-Zaid 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
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.
format	article
author	Saeed Baradwan Sahar Hassan Abdulghani Mohammed Abuzaid Khalid Khadawardi Majed Saeed Alshahrani Abdulrahman Al-Matary May A. AlRasheed Najlaa Talat Miski Aroob Abdulhalim Yousra Mansour Alturki Ahmed Abu-Zaid
author_facet	Saeed Baradwan Sahar Hassan Abdulghani Mohammed Abuzaid Khalid Khadawardi Majed Saeed Alshahrani Abdulrahman Al-Matary May A. AlRasheed Najlaa Talat Miski Aroob Abdulhalim Yousra Mansour Alturki Ahmed Abu-Zaid
author_sort	Saeed Baradwan
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_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_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_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
publisher	Korean Society of Obstetrics and Gynecology
publishDate	2021
url	https://doaj.org/article/b5167d9351e5495eb8ff5f40cc4c85cb
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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

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