Weekly Progesterone Derivative Injections Could Have Prevented 10,000 Premature Births in 2002, Study Says

If pregnant women who were at high risk of delivering prematurely had received weekly injections of a drug derived from the hormone progesterone, almost 10,000 premature single births in the U.S. in 2002 could have been prevented, reducing the overall rate by about 2%, according to a study published in the February issue of Obstetrics & Gynecology, Reuters reports. Joann Petrini and colleagues from the March of Dimes, CDC, National Institute of Child Health and Human Development and other centers studied the hormone derivative -- known as 17 alpha-hydroxyprogesterone caproate, or 17P -- and estimated that about 30,000 women who delivered premature babies in 2002 could have been helped by the use of 17P. If about 33% of the women carried their pregnancies to term, 10,000 premature births would have been prevented, the researchers said. Although the researchers do not understand how the drug prevents premature delivery, previous studies have suggested it helps, according to Reuters (Reuters, 1/31).

Previous Study
According to an NIH-funded study published in the New England Journal of Medicine in June 2003, Dr. Paul Meis of Wake Forest University and colleagues conducted a double-blind, placebo-controlled study at 19 clinical centers across the nation involving pregnant women at 16 to 20 weeks of gestation, each of whom had a documented history of spontaneous early delivery. Researchers assigned 310 women to receive weekly injections of 250 mg of 17P and 153 women to receive weekly injections of an inert oil placebo. All participants received injections until delivery or up to 36 weeks gestation. Researchers found that 36% of the women who received progesterone injections delivered before 37 weeks gestation, compared with 55% of women who received the placebo. In addition, progesterone appeared to be "even more effective" during the earlier weeks of pregnancy, with only 11% of women who received progesterone delivering before 32 weeks, compared with 20% of women in the placebo group (Kaiser Daily Reproductive Health Report, 6/12/03). A November 2003 opinion issued by the American College of Obstetricians and Gynecologists' Committee on Obstetric Practice calls for additional research on the 17P's role in preventing premature birth and reminds doctors to restrict the use of 17P to pregnant women with a history of spontanteous premature birth at less than 37 weeks of gestation (ACOG release, 10/31/03). According to the March of Dimes, more than 470,000 infants are born prematurely each year, and the rate of premature births in the United States has risen 29% since 1981 (March of Dimes release, 1/31).



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