A total of 790 women with prior SPTD received care through a managed Medicaid health plan.
In all, 28% of women had SPTD prior to 37 weeks, 12% had SPTD prior to 35 weeks, and 6% had SPTD prior to 32 weeks.
In terms of early discontinuation of 17P, 38% of mothers who discontinued 17P use early had SPTD at less than 37 weeks' gestation, compared with only 26% of women who did not discontinue 17R Likewise, 23% of mothers who discontinued 17P use early had SPTD at less than 35 weeks, compared with only 10% of women who did not discontinue; 12% of mothers who discontinued 17P use early had SPTD at less than 32 weeks, compared with only 4% of women who did not discontinue.
"Early discontinuation of 17P increases a patient's risk for recurrent SPTD," said Dr.
Still, "current information would suggest that 17P be offered to all women with a history of prior SPTD in a current singleton pregnancy, even if they have experienced a term gestation, especially now with the Food and Drug Administration's approval of 17P," he said at the meeting.
Investigators have noted a lack of direct data on the benefit of 17P in women with a prior term birth followed by SPTD, Dr.
He and his colleagues studied women with a singleton pregnancy who received weekly 250-mg intramuscular injections of 17P through a home administration program because of previous SPTD. Treatment began before 25 weeks' gestation and continued until 36 completed weeks or preterm delivery.
About 70% of the women had previously experienced just one SPTD, while the other 30% had experienced more than one, reported Dr.
In the group who had just one SPTD, women with a prior term birth were significantly less likely than those without a prior term birth to have a recurrent SPTD before 37 weeks' gestation (odds ratio, 0.83), and also before 35 weeks (OR, 0.73) and before 32 weeks (OR, 0.74).
In a multivariate logistic regression analysis, a prior term birth still significantly protected against recurrent SPTD before 37 weeks (OR, 0.83; P = .01).
In the group who had more than one SPTD, women with a prior term birth were significantly less likely to have a recurrent SPTD before 37 weeks' gestation (OR, 0.79) but not before 35 or 32 weeks.