Date of Award

2021

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is 17- alpha hydroxyprogesterone effective for preventing preterm labor in high risk women?”.

STUDY DESIGN: Review of one randomized, double blind, controlled trial, one randomized, double blind, placebo controlled trial and one randomized controlled trial published in English between 2015 and 2018.

DATA SOURCES: All three studies were gathered from peer- reviewed journals and found using PubMed.

OUTCOMES MEASURED: Preterm delivery defined as birth less than 37 weeks gestation for Facchinetti et al., Shadab et al. and Winer et al.6,7,8

RESULTS: The RCT performed by Facchinetti et al. showed no statistically significant reduction in rates of preterm labor in the patients treated with 17 alpha-hydroxyprogesterone in comparison with the control group (p = 0.949). The preterm birth rate in the progesterone group was 23% vs. 22% in the control group.6 Similarly, Winer et al. found that progesterone supplementation was not effective in reducing rates of preterm labor with p>0.99. The preterm birth rate in the progesterone group was 45% vs 44% in the control group.8 Conversely, Shadab et al. found significant reduction of preterm birth rates treating with 17-alpha hydroxyprogesterone compared to a control group (p<0.05). The preterm birth rate in the progesterone group was 28.79% vs 59.09% in the control group.7

CONCLUSIONS: The three RCTs utilized for this review did not hold consistent data in determining whether 17 alpha-hydroxyprogesterone supplementation is effective in reducing rates of preterm birth. Facchinetti et al. and Winer et al. demonstrated no statistically significant reduction in preterm birth rates whereas Shadab et al. found a statistically significant reduction in rates.6,7,8 The research utilized for this review held inconclusive results and revealed limitations within each study. Further research is needed to better evaluate the effects of 17 alpha hydroxyprogesterone supplementation in reducing preterm birth rates.

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