17‐Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta‐analysis
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‐hydroxyprogesteron...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2016-04, Vol.123 (5), p.682-690 |
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| container_title | BJOG : an international journal of obstetrics and gynaecology |
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| creator | Combs, CA Schuit, E Caritis, SN Lim, AC Garite, TJ Maurel, K Rouse, D Thom, E Tita, AT Mol, BWJ |
| description | 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 |
| doi_str_mv | 10.1111/1471-0528.13779 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5896762</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1787471408</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4679-89decd3a5023d208eddecc41702157f2299673c9554a22a3c03163ee657545513</originalsourceid><addsrcrecordid>eNqFkc9u1DAQxi1ERUvhzA1F4tJLWv-J7YQDUqmAUlXqBc7W1J5dXGXtYCelufEIPCNPgtMtK-CCL57x_PxpZj5CXjB6zMo5YY1mNZW8PWZC6-4ROdi9PL6PaU0Fb_fJ05xvKGWKU_GE7HOllCjxAblm-uf3H-ezS_FuHlJcYx4xxYCVhZLCiJUP1Zj80ONYDQnXAYKdX1cQSsH5W-8m6KsBRo9hrByMUG1whCIKAfo5-_yM7K2gz_j84T4kn9-_-3R2Xl9effh4dnpZ20bprm47h9YJkJQLx2mLruS2YZpyJvWK865TWthOygY4B2GpYEogKqllIyUTh-TNVneYrjfobOknQW-G5DeQZhPBm78rwX8x63hrZFuUFS8CRw8CKX6dyiLMxmeLfQ8B45QN060u221oW9BX_6A3cUpl4IUqkFgcKNTJlrIp5pxwtWuGUbP4Zxa3zMKae__Kj5d_zrDjfxtWALkFvvke5__pmbcXV1vhX1JVp3Q</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1774730528</pqid></control><display><type>article</type><title>17‐Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta‐analysis</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Combs, CA ; Schuit, E ; Caritis, SN ; Lim, AC ; Garite, TJ ; Maurel, K ; Rouse, D ; Thom, E ; Tita, AT ; Mol, BWJ</creator><creatorcontrib>Combs, CA ; Schuit, E ; Caritis, SN ; Lim, AC ; Garite, TJ ; Maurel, K ; Rouse, D ; Thom, E ; Tita, AT ; Mol, BWJ ; Global Obstetrics Network (GONet) collaboration ; A Global Obstetrics Network (GONet) collaboration</creatorcontrib><description>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.
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17‐Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.
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17‐Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.13779</identifier><identifier>PMID: 26663620</identifier><identifier>CODEN: BIOGFQ</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>17‐Hydroxyprogesterone caproate ; Female ; Humans ; Hydroxyprogesterones - therapeutic use ; Meta-analysis ; multiple gestation ; Pregnancy ; Pregnancy, Triplet ; Premature birth ; Premature Birth - prevention & control ; preterm birth prevention ; Progestins - therapeutic use ; progestogens ; Treatment Outcome ; triplet pregnancy</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2016-04, Vol.123 (5), p.682-690</ispartof><rights>2015 Royal College of Obstetricians and Gynaecologists</rights><rights>2015 Royal College of Obstetricians and Gynaecologists.</rights><rights>Copyright © 2016 Royal College of Obstetricians and Gynaecologists</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4679-89decd3a5023d208eddecc41702157f2299673c9554a22a3c03163ee657545513</citedby><cites>FETCH-LOGICAL-c4679-89decd3a5023d208eddecc41702157f2299673c9554a22a3c03163ee657545513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.13779$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.13779$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26663620$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Combs, CA</creatorcontrib><creatorcontrib>Schuit, E</creatorcontrib><creatorcontrib>Caritis, SN</creatorcontrib><creatorcontrib>Lim, AC</creatorcontrib><creatorcontrib>Garite, TJ</creatorcontrib><creatorcontrib>Maurel, K</creatorcontrib><creatorcontrib>Rouse, D</creatorcontrib><creatorcontrib>Thom, E</creatorcontrib><creatorcontrib>Tita, AT</creatorcontrib><creatorcontrib>Mol, BWJ</creatorcontrib><creatorcontrib>Global Obstetrics Network (GONet) collaboration</creatorcontrib><creatorcontrib>A Global Obstetrics Network (GONet) collaboration</creatorcontrib><title>17‐Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta‐analysis</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>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
17‐Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.
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17‐Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.</description><subject>17‐Hydroxyprogesterone caproate</subject><subject>Female</subject><subject>Humans</subject><subject>Hydroxyprogesterones - therapeutic use</subject><subject>Meta-analysis</subject><subject>multiple gestation</subject><subject>Pregnancy</subject><subject>Pregnancy, Triplet</subject><subject>Premature birth</subject><subject>Premature Birth - prevention & control</subject><subject>preterm birth prevention</subject><subject>Progestins - therapeutic use</subject><subject>progestogens</subject><subject>Treatment Outcome</subject><subject>triplet pregnancy</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9u1DAQxi1ERUvhzA1F4tJLWv-J7YQDUqmAUlXqBc7W1J5dXGXtYCelufEIPCNPgtMtK-CCL57x_PxpZj5CXjB6zMo5YY1mNZW8PWZC6-4ROdi9PL6PaU0Fb_fJ05xvKGWKU_GE7HOllCjxAblm-uf3H-ezS_FuHlJcYx4xxYCVhZLCiJUP1Zj80ONYDQnXAYKdX1cQSsH5W-8m6KsBRo9hrByMUG1whCIKAfo5-_yM7K2gz_j84T4kn9-_-3R2Xl9effh4dnpZ20bprm47h9YJkJQLx2mLruS2YZpyJvWK865TWthOygY4B2GpYEogKqllIyUTh-TNVneYrjfobOknQW-G5DeQZhPBm78rwX8x63hrZFuUFS8CRw8CKX6dyiLMxmeLfQ8B45QN060u221oW9BX_6A3cUpl4IUqkFgcKNTJlrIp5pxwtWuGUbP4Zxa3zMKae__Kj5d_zrDjfxtWALkFvvke5__pmbcXV1vhX1JVp3Q</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Combs, CA</creator><creator>Schuit, E</creator><creator>Caritis, SN</creator><creator>Lim, AC</creator><creator>Garite, TJ</creator><creator>Maurel, K</creator><creator>Rouse, D</creator><creator>Thom, E</creator><creator>Tita, AT</creator><creator>Mol, BWJ</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201604</creationdate><title>17‐Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta‐analysis</title><author>Combs, CA ; Schuit, E ; Caritis, SN ; Lim, AC ; Garite, TJ ; Maurel, K ; Rouse, D ; Thom, E ; Tita, AT ; Mol, BWJ</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4679-89decd3a5023d208eddecc41702157f2299673c9554a22a3c03163ee657545513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>17‐Hydroxyprogesterone caproate</topic><topic>Female</topic><topic>Humans</topic><topic>Hydroxyprogesterones - therapeutic use</topic><topic>Meta-analysis</topic><topic>multiple gestation</topic><topic>Pregnancy</topic><topic>Pregnancy, Triplet</topic><topic>Premature birth</topic><topic>Premature Birth - prevention & control</topic><topic>preterm birth prevention</topic><topic>Progestins - therapeutic use</topic><topic>progestogens</topic><topic>Treatment Outcome</topic><topic>triplet pregnancy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Combs, CA</creatorcontrib><creatorcontrib>Schuit, E</creatorcontrib><creatorcontrib>Caritis, SN</creatorcontrib><creatorcontrib>Lim, AC</creatorcontrib><creatorcontrib>Garite, TJ</creatorcontrib><creatorcontrib>Maurel, K</creatorcontrib><creatorcontrib>Rouse, D</creatorcontrib><creatorcontrib>Thom, E</creatorcontrib><creatorcontrib>Tita, AT</creatorcontrib><creatorcontrib>Mol, BWJ</creatorcontrib><creatorcontrib>Global Obstetrics Network (GONet) collaboration</creatorcontrib><creatorcontrib>A Global Obstetrics Network (GONet) collaboration</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Combs, CA</au><au>Schuit, E</au><au>Caritis, SN</au><au>Lim, AC</au><au>Garite, TJ</au><au>Maurel, K</au><au>Rouse, D</au><au>Thom, E</au><au>Tita, AT</au><au>Mol, BWJ</au><aucorp>Global Obstetrics Network (GONet) collaboration</aucorp><aucorp>A Global Obstetrics Network (GONet) collaboration</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>17‐Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta‐analysis</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2016-04</date><risdate>2016</risdate><volume>123</volume><issue>5</issue><spage>682</spage><epage>690</epage><pages>682-690</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><coden>BIOGFQ</coden><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
17‐Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.
Tweetable
17‐Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>26663620</pmid><doi>10.1111/1471-0528.13779</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1470-0328 |
| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2016-04, Vol.123 (5), p.682-690 |
| issn | 1470-0328 1471-0528 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5896762 |
| source | MEDLINE; Access via Wiley Online Library |
| subjects | 17‐Hydroxyprogesterone caproate Female Humans Hydroxyprogesterones - therapeutic use Meta-analysis multiple gestation Pregnancy Pregnancy, Triplet Premature birth Premature Birth - prevention & control preterm birth prevention Progestins - therapeutic use progestogens Treatment Outcome triplet pregnancy |
| title | 17‐Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta‐analysis |
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