17-alpha hydroxyprogesterone caproate for preterm birth prevention: Where have we been,how did we get here,and where are we going? |
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| Institution: | 1. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, P.O. Box 208063, New Haven, CT 06520-8063;2. Department of Neonatology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215;1. Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA;2. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA;3. Department of Pharmacology, Vanderbilt University, Nashville, TN, USA;1. Department of Pediatrics, University of British Columbia, Vancouver, British Columbia;2. Center for Women''s and Infant''s Health at the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada;3. Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada;4. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada;5. Maternal-Infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada |
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| Abstract: | Prematurity is a major public health problem in the United States and worldwide. Women with a history of a previous preterm birth are at high risk for recurrence. Progesterone is a key hormone involved in pregnancy maintenance. In general, progesterone is thought to maintain pregnancy through several closely linked mechanisms: (1) promotion of uterine quiescence, (2) inhibition of pro-inflammatory cells, and (3) immunosuppressive action. 17-Alpha hydroxyprogesterone caproate is currently the only medication approved to prevent recurrent preterm birth. The purpose of this review is to discuss the history of 17-alpha hydroxyprogesterone caproate use for recurrent preterm birth prevention, the rationale behind 17-alpha hydroxyprogesterone caproate administration, and current evidence-based indications for 17-alpha hydroxyprogesterone caproate use. |
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| Keywords: | Recurrent preterm birth 17-alpha hydroxyprogesterone caproate Perinatal epidemiology Spontaneous preterm labor |
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