AUTHOR=Almutairi Abdulaali R. , Aljohani Hadir I. , Al-fadel Nouf S. 

TITLE=17-Alpha-Hydroxyprogesterone vs. Placebo for Preventing of Recurrent Preterm Birth: A Systematic Review and Meta-Analysis of Randomized Trials

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.764855

DOI=10.3389/fmed.2021.764855

ISSN=2296-858X

ABSTRACT=Background: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.
Objective: To estimate the effect of 17-OHPC compared to placebo in singleton gestations for reducing the risk of recurrent PTB and neonatal morbidity and mortality.
Search strategy: Searching Medline, Embase, Web of Science, SCOPUS, Cochrane Library, and clinical trial registries.
Selection criteria: Randomized controlled trials of singleton gestations with a history of PTB and treated with a weekly intramuscular-injection of 17‐OHPC or placebo. 
Data collection and analysis: A random meta-analysis model was performed for the PTB outcomes (<32, <35, and <37 weeks) and neonatal outcomes (neonatal death, grade 3/4 intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and sepsis). Effect estimates were measured by relative risk (RR) with a 95% confidence interval (95%CI). 
Main results: Six studies were included. 17-OHPC was not associated with a reduction in the PTB risk at <32 weeks (RR 0.61, 95%CI 0.13-2.77, I2 39%), <35weeks (RR 0.60, 95%CI 0.10-3.67, I2 51%), and <37 weeks (RR 0.68, 95%CI 0.46-1, I2 75%). Furthermore, all the neonatal outcomes were statistically similar between the two groups
Conclusion: treatment with 17-OHPC is not associated with reducing the risk of PTB or neonatal outcomes compared to placebo.