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Progesterone injections do not prevent preterm birth in twin pregnancies

CHAPEL HILL -- Weekly progesterone injections do not prevent premature births in women pregnant with twins, a University of North Carolina at Chapel Hill study has found.

The result came as a surprise to the researchers, who previously discovered that weekly injections of the naturally occurring hormone, called 17 alpha-hydroxyprogesterone or 17-OHPC, reduced additional preterm births by one-third in women whose previous babies were born prematurely.

Based on the results of the first study, which showed that 17-OHPC reduced preterm birth in the group with the highest risk, we were hopeful that it would also prevent preterm birth in twin pregnancies, which represents an intermediate level of risk, said John Thorp, M.D., a study co-author and professor of obstetrics and gynecology UNC-Chapel Hill. The mechanisms that lead to preterm birth are complex, and I think our current study shows they may not be amenable to a single solution.

The study results are published in the Aug. 2 issue of The New England Journal of Medicine. The lead author is Dwight J. Rouse, M.D., of the University of Alabama at Birmingham. The study was conducted for the Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development, which provided grant funding. It took place at 14 sites across the United States, including UNC-Chapel Hill, WakeMed and the Wake County Health Department.

For the study, 655 healthy women with twin pregnancies and no prior preterm births received weekly injections of either 17-OHPC or placebo, starting at 16 to 20 weeks into their pregnancies and ending at 35 weeks. The results showed no meaningful difference between the 17-OHPC and placebo groups. Birth or miscarriage before 35 weeks gestation occurred in 41.5 percent of the 17-OHPC group and in 37.3 percent of the placebo group.

The researchers concluded that treatment with 17-OHPC did not reduce the rate of preterm birth in wo
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Contact: Clinton Colmenares
clinton_colmenares@unc.edu
919-843-1991
University of North Carolina at Chapel Hill
1-Aug-2007


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