The PROLONG trial found that 17-hydroxyprogesterone caproate (17-OHP) did not lead to a reduction in recurrent preterm birth (PTB) prior to 35 weeks. The objective of this study is to assess use of 17-OHP before and after the publication of PROLONG and whether there was any change in the rate of recurrent PTB.
We included all women with a history of spontaneous PTB who delivered at a single tertiary care hospital. We compared 17-OHP use and birth outcomes among patients who delivered before and after the PROLONG trial.
There were 417 patients included in the study (196 in Year 1 and 221 in Year 2). There were no differences in baseline characteristics. The use of 17-OHP declined dramatically, from 62.2% in Year 1 to 14.9% in Year 2: p< 0.01. However, there was no difference in birth outcomes. The mean gestational age of delivery was similar between years (37.1 weeks vs 37.2 weeks, p= 0.72). There was also no difference in the proportion of preterm birth that was spontaneous versus indicated.
Despite a 4-fold reduction in 17-OHP use at our hospital, we found no difference in the rate of recurrent preterm birth.