17-Hydroxyprogesterone caproate in triplet pregnancy

An individual patient data meta-analysis

C. A. Combs, E. Schuit, S. N. Caritis, A. C. Lim, T. J. Garite, K. Maurel, D. Rouse, E. Thom, A. T. Tita, B. W.J. Mol, A Global Obstetrics Network (GONet) collaboration

Research output: Contribution to journalReview ArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Background Preterm birth complicates almost all triplet pregnancies and no preventive strategy has proven effective. Objective To determine, using individual patient data (IPD) meta-analysis, whether the outcome of triplet pregnancy is affected by prophylactic administration of 17-hydroxyprogesterone caproate (17OHPc). Search strategy We searched literature databases, trial registries and references in published articles. Selection criteria Randomised controlled trials (RCTs) of progestogens versus control that included women with triplet pregnancies. Data collection and analysis Investigators from identified RCTs collaborated on the protocol and contributed their IPD. The primary outcome was a composite measure of adverse perinatal outcome. The secondary outcome was the rate of birth before 32 weeks of gestation. Other pre-specified outcomes included randomisation-to-delivery interval and rates of birth at <24, <28 and <34 weeks of gestation. Main results Three RCTs of 17OHPc versus placebo included 232 mothers with triplet pregnancies and their 696 offspring. Risk-of-bias scores and between-study heterogeneity were low. Baseline characteristics were comparable between 17OHPc and placebo groups. The rate of the composite adverse perinatal outcome was similar among those treated with 17OHPc and those treated with placebo (34 and 35%, respectively; risk ratio [RR] 0.98, 95% confidence interval [95% CI] 0.79-1.2). The rate of birth at <32 weeks was also similar in the two groups (35 and 38%, respectively; RR 0.92, 95% CI 0.55-1.56). There were no significant between-group differences in perinatal mortality rate, randomisation-to-delivery interval, or other specified outcomes. Conclusion Prophylactic 17OHPc given to mothers with triplet pregnancies had no significant impact on perinatal outcome or pregnancy duration. Tweetable abstract 17-Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.

Original languageEnglish
Pages (from-to)682-690
Number of pages9
JournalBJOG: an International Journal of Obstetrics and Gynaecology
Volume123
Issue number5
DOIs
Publication statusPublished - 1 Apr 2016
Externally publishedYes

Keywords

  • 17-Hydroxyprogesterone caproate
  • Multiple gestation
  • Preterm birth prevention
  • Progestogens
  • Triplet pregnancy

Cite this

Combs, C. A., Schuit, E., Caritis, S. N., Lim, A. C., Garite, T. J., Maurel, K., ... A Global Obstetrics Network (GONet) collaboration (2016). 17-Hydroxyprogesterone caproate in triplet pregnancy: An individual patient data meta-analysis. BJOG: an International Journal of Obstetrics and Gynaecology, 123(5), 682-690. https://doi.org/10.1111/1471-0528.13779
Combs, C. A. ; Schuit, E. ; Caritis, S. N. ; Lim, A. C. ; Garite, T. J. ; Maurel, K. ; Rouse, D. ; Thom, E. ; Tita, A. T. ; Mol, B. W.J. ; A Global Obstetrics Network (GONet) collaboration. / 17-Hydroxyprogesterone caproate in triplet pregnancy : An individual patient data meta-analysis. In: BJOG: an International Journal of Obstetrics and Gynaecology. 2016 ; Vol. 123, No. 5. pp. 682-690.
@article{b3b2d084dacb447e9bb85da3131a0d63,
title = "17-Hydroxyprogesterone caproate in triplet pregnancy: An individual patient data meta-analysis",
abstract = "Background Preterm birth complicates almost all triplet pregnancies and no preventive strategy has proven effective. Objective To determine, using individual patient data (IPD) meta-analysis, whether the outcome of triplet pregnancy is affected by prophylactic administration of 17-hydroxyprogesterone caproate (17OHPc). Search strategy We searched literature databases, trial registries and references in published articles. Selection criteria Randomised controlled trials (RCTs) of progestogens versus control that included women with triplet pregnancies. Data collection and analysis Investigators from identified RCTs collaborated on the protocol and contributed their IPD. The primary outcome was a composite measure of adverse perinatal outcome. The secondary outcome was the rate of birth before 32 weeks of gestation. Other pre-specified outcomes included randomisation-to-delivery interval and rates of birth at <24, <28 and <34 weeks of gestation. Main results Three RCTs of 17OHPc versus placebo included 232 mothers with triplet pregnancies and their 696 offspring. Risk-of-bias scores and between-study heterogeneity were low. Baseline characteristics were comparable between 17OHPc and placebo groups. The rate of the composite adverse perinatal outcome was similar among those treated with 17OHPc and those treated with placebo (34 and 35{\%}, respectively; risk ratio [RR] 0.98, 95{\%} confidence interval [95{\%} CI] 0.79-1.2). The rate of birth at <32 weeks was also similar in the two groups (35 and 38{\%}, respectively; RR 0.92, 95{\%} CI 0.55-1.56). There were no significant between-group differences in perinatal mortality rate, randomisation-to-delivery interval, or other specified outcomes. Conclusion Prophylactic 17OHPc given to mothers with triplet pregnancies had no significant impact on perinatal outcome or pregnancy duration. Tweetable abstract 17-Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.",
keywords = "17-Hydroxyprogesterone caproate, Multiple gestation, Preterm birth prevention, Progestogens, Triplet pregnancy",
author = "Combs, {C. A.} and E. Schuit and Caritis, {S. N.} and Lim, {A. C.} and Garite, {T. J.} and K. Maurel and D. Rouse and E. Thom and Tita, {A. T.} and Mol, {B. W.J.} and {A Global Obstetrics Network (GONet) collaboration}",
year = "2016",
month = "4",
day = "1",
doi = "10.1111/1471-0528.13779",
language = "English",
volume = "123",
pages = "682--690",
journal = "BJOG: an International Journal of Obstetrics and Gynaecology",
issn = "1470-0328",
publisher = "Wiley-Blackwell",
number = "5",

}

Combs, CA, Schuit, E, Caritis, SN, Lim, AC, Garite, TJ, Maurel, K, Rouse, D, Thom, E, Tita, AT, Mol, BWJ & A Global Obstetrics Network (GONet) collaboration 2016, '17-Hydroxyprogesterone caproate in triplet pregnancy: An individual patient data meta-analysis', BJOG: an International Journal of Obstetrics and Gynaecology, vol. 123, no. 5, pp. 682-690. https://doi.org/10.1111/1471-0528.13779

17-Hydroxyprogesterone caproate in triplet pregnancy : An individual patient data meta-analysis. / Combs, C. A.; Schuit, E.; Caritis, S. N.; Lim, A. C.; Garite, T. J.; Maurel, K.; Rouse, D.; Thom, E.; Tita, A. T.; Mol, B. W.J.; A Global Obstetrics Network (GONet) collaboration.

In: BJOG: an International Journal of Obstetrics and Gynaecology, Vol. 123, No. 5, 01.04.2016, p. 682-690.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - 17-Hydroxyprogesterone caproate in triplet pregnancy

T2 - An individual patient data meta-analysis

AU - Combs, C. A.

AU - Schuit, E.

AU - Caritis, S. N.

AU - Lim, A. C.

AU - Garite, T. J.

AU - Maurel, K.

AU - Rouse, D.

AU - Thom, E.

AU - Tita, A. T.

AU - Mol, B. W.J.

AU - A Global Obstetrics Network (GONet) collaboration

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Background Preterm birth complicates almost all triplet pregnancies and no preventive strategy has proven effective. Objective To determine, using individual patient data (IPD) meta-analysis, whether the outcome of triplet pregnancy is affected by prophylactic administration of 17-hydroxyprogesterone caproate (17OHPc). Search strategy We searched literature databases, trial registries and references in published articles. Selection criteria Randomised controlled trials (RCTs) of progestogens versus control that included women with triplet pregnancies. Data collection and analysis Investigators from identified RCTs collaborated on the protocol and contributed their IPD. The primary outcome was a composite measure of adverse perinatal outcome. The secondary outcome was the rate of birth before 32 weeks of gestation. Other pre-specified outcomes included randomisation-to-delivery interval and rates of birth at <24, <28 and <34 weeks of gestation. Main results Three RCTs of 17OHPc versus placebo included 232 mothers with triplet pregnancies and their 696 offspring. Risk-of-bias scores and between-study heterogeneity were low. Baseline characteristics were comparable between 17OHPc and placebo groups. The rate of the composite adverse perinatal outcome was similar among those treated with 17OHPc and those treated with placebo (34 and 35%, respectively; risk ratio [RR] 0.98, 95% confidence interval [95% CI] 0.79-1.2). The rate of birth at <32 weeks was also similar in the two groups (35 and 38%, respectively; RR 0.92, 95% CI 0.55-1.56). There were no significant between-group differences in perinatal mortality rate, randomisation-to-delivery interval, or other specified outcomes. Conclusion Prophylactic 17OHPc given to mothers with triplet pregnancies had no significant impact on perinatal outcome or pregnancy duration. Tweetable abstract 17-Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.

AB - Background Preterm birth complicates almost all triplet pregnancies and no preventive strategy has proven effective. Objective To determine, using individual patient data (IPD) meta-analysis, whether the outcome of triplet pregnancy is affected by prophylactic administration of 17-hydroxyprogesterone caproate (17OHPc). Search strategy We searched literature databases, trial registries and references in published articles. Selection criteria Randomised controlled trials (RCTs) of progestogens versus control that included women with triplet pregnancies. Data collection and analysis Investigators from identified RCTs collaborated on the protocol and contributed their IPD. The primary outcome was a composite measure of adverse perinatal outcome. The secondary outcome was the rate of birth before 32 weeks of gestation. Other pre-specified outcomes included randomisation-to-delivery interval and rates of birth at <24, <28 and <34 weeks of gestation. Main results Three RCTs of 17OHPc versus placebo included 232 mothers with triplet pregnancies and their 696 offspring. Risk-of-bias scores and between-study heterogeneity were low. Baseline characteristics were comparable between 17OHPc and placebo groups. The rate of the composite adverse perinatal outcome was similar among those treated with 17OHPc and those treated with placebo (34 and 35%, respectively; risk ratio [RR] 0.98, 95% confidence interval [95% CI] 0.79-1.2). The rate of birth at <32 weeks was also similar in the two groups (35 and 38%, respectively; RR 0.92, 95% CI 0.55-1.56). There were no significant between-group differences in perinatal mortality rate, randomisation-to-delivery interval, or other specified outcomes. Conclusion Prophylactic 17OHPc given to mothers with triplet pregnancies had no significant impact on perinatal outcome or pregnancy duration. Tweetable abstract 17-Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.

KW - 17-Hydroxyprogesterone caproate

KW - Multiple gestation

KW - Preterm birth prevention

KW - Progestogens

KW - Triplet pregnancy

UR - http://www.scopus.com/inward/record.url?scp=84953426149&partnerID=8YFLogxK

U2 - 10.1111/1471-0528.13779

DO - 10.1111/1471-0528.13779

M3 - Review Article

VL - 123

SP - 682

EP - 690

JO - BJOG: an International Journal of Obstetrics and Gynaecology

JF - BJOG: an International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 5

ER -