ABSTRACT
OBJECTIVE: To determine if gestational age of prior preterm delivery influences a woman's receipt of 17-hydroxyprogesterone caproate (17-OHP-C). METHODS: Retrospective cohort of women eligible for 17-OHP-C at Duke Obstetrics Clinic were identified by medical record review. Sociodemographic and clinical characteristics were abstracted. Results. Of 104 eligible subjects, 82 (78.8%) were offered 17-OHP-C. Of these, thirty-four (41.5%) declined. The median gestational age of the most recent preterm delivery was significantly lower among subjects who accepted 17-OHP-C as compared to those who declined (28.7 vs. 34.0 weeks, P = .02) and in subjects offered 17-OHP-C compared to those not offered 17-OHP-C (30.2 vs. 36.0 weeks, P = .03). Subjects not offered 17-OHP-C were more likely to have had an interval term delivery (31.8% vs. 9.7%, P = .009) CONCLUSION: Women with earlier preterm deliveries were more likely to be offered and accept 17-OHP-C. Prior obstetric history may influence both providers' and patients' willingness to discuss and/or accept 17-OHP-C.
Subject(s)
Gestational Age , Hydroxyprogesterones/therapeutic use , Patient Acceptance of Health Care/psychology , Premature Birth/prevention & control , Progestins/therapeutic use , 17 alpha-Hydroxyprogesterone Caproate , Adult , Female , Humans , Practice Patterns, Physicians' , Pregnancy , Pregnancy, High-Risk , Premature Birth/psychology , Retrospective Studies , Secondary Prevention , Term Birth/psychology , Treatment Refusal/psychology , Young AdultABSTRACT
OBJECTIVE: This study was undertaken to determine whether the interleukin-1 receptor antagonist (IL-1RN) variable number tandem repeat polymorphism is associated with preterm birth. STUDY DESIGN: A case-control study was performed. Cases (n = 95) delivered before 37 weeks after preterm labor (PTL) or preterm premature rupture of membranes (PPROM) and controls (n = 105) delivered after 37 weeks. Maternal DNA was genotyped by polymerase chain reaction for a length polymorphism in intron 2 of the IL-1RN gene. RESULTS: There was no significant difference in maternal age, ethnicity, insurance status, or parity between groups. Allele and genotype frequencies did not differ significantly from that expected under Hardy-Weinberg equilibrium (P = .59) in the total group as well as study groups. Of the 95 cases, 26.8% had at least 1 copy of allele 2 present compared with 12.4% in the control group (P < .0004). CONCLUSION: Maternal carriage of at least 1 copy of the IL-1RN allele 2 appears to be associated with increased risk of preterm birth.
