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Prevention of Preterm Birth in Triplets Using 17 Alpha-Hydroxyprogesterone Caproate


Caritis, Steve N.; Rouse, Dwight J.; Peaceman, Alan M.; Sciscione, Anthony C.; Momirova, Valerija; Spong, Catherine Y.; Iams, Jay D.; Wapner, Ronald J.; Varner, Michael W.; & Carpenter, Marshall W., et al. (2009). Prevention of Preterm Birth in Triplets Using 17 Alpha-Hydroxyprogesterone Caproate. Obstetrics & Gynecology, 113(2, Part 1), 285-292. PMCID: PMC2790283


OBJECTIVE: To assess whether 17 alpha-hydroxyprogesterone caproate reduces the rate of preterm birth in women carrying triplets.
METHODS: We performed this randomized, double-blinded, placebo-controlled trial in 14 centers. Healthy women with triplets were randomly assigned to weekly intramuscular injections of either 250 mg of 17 alpha-hydroxyprogesterone caproate or matching placebo, starting at 16-20 weeks and ending at delivery or 35 weeks of gestation. The primary study outcome was delivery or fetal loss before 35 weeks.
RESULTS: One hundred thirty-four women were assigned, 71 to 17 alpha-hydroxyprogesterone caproate and 63 to placebo; none were lost to follow-up. Baseline demographic data were similar in the two groups. The proportion of women experiencing the primary outcome (a composite of delivery or fetal loss before 35 0/7 weeks) was similar in the two treatment groups: 83% of pregnancies in the 17 alpha-hydroxyprogesterone caproate group and 84% in the placebo group, relative risk 1.0, 95% confidence interval 0.9-1.1. The lack of benefit of 17 alpha-hydroxyprogesterone caproate was evident regardless of the conception method or whether a gestational age cutoff for delivery was set at 32 or 28 weeks.
CONCLUSION: Treatment with 17 alpha-hydroxyprogesterone caproate did not reduce the rate of preterm birth in women with triplet gestations.


Reference Type

Journal Article

Year Published


Journal Title

Obstetrics & Gynecology


Caritis, Steve N.
Rouse, Dwight J.
Peaceman, Alan M.
Sciscione, Anthony C.
Momirova, Valerija
Spong, Catherine Y.
Iams, Jay D.
Wapner, Ronald J.
Varner, Michael W.
Carpenter, Marshall W.
Lo, Julie
Thorp, John M., Jr.
Mercer, Brian M.
Sorokin, Yoram
Harper, Margaret A.
Ramin, Susan M.
Anderson, Garland D., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network