17α Hydroxyprogesterone caproate for prevention of recurrent spontaneous preterm birth

Use of 17-alpha-hydroxyprogesterone caproate for the prevention of spontaneous preterm birth in women at risk is reviewed. Early studies regarding this topic reached contradicting conclusions, however recent studies showed that weekly injections of 17-alpha-hydroxyprogesterone caproate beginning at 16–20 weeks’ gestation resulted in a substantial reduction in the rate of spontaneous recurrent preterm birth. Long-term follow-up of children exposed in-utero to the drug has shown normal growth and development and normal scores for gender specific roles. In conclusion, 17-alpha-hydroxyprogesterone caproate is currently the only drug with sufficient evidence to support its use for prevention of spontaneous recurrent preterm birth.

► 17-α-Hydroxyprogesterone caproate is effective for prevention of spontaneous preterm birth for women at risk.
► 17-α-Hydroxyprogesterone caproate may be used from 16 weeks of gestation at a weekly dose of 250 mg.
► 2nd and 3rd trimester use of 17-α-hydroxyprogesterone caproate was not associated with adverse effects in children.
► Drug use for additional high-risk pregnancy conditions requires further research.