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Regional differences in utilization of 17α-hydroxyprogesterone caproate (17-OHP)

  • Jessica M. Hart ORCID logo EMAIL logo , Joe B. Hakim , Blair J. Wylie and Andrew L. Beam
Published/Copyright: June 3, 2022
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 50 Issue 9

Abstract

Objectives

To describe regional differences in utilization of 17α-hydroxyprogesterone caproate (17-OHP).

Methods

Retrospective cohort study of a large, US commercial managed care plan claims database with pharmacy coverage from 2008 to 2018. Singleton pregnancies with at least one prior spontaneous preterm birth (sPTB) were included. Regional and state-based differences in 17-OHP use were compared. Data were analyzed using t-tests and Fisher’s exact tests.

Results

Of the 4,514 individuals with an indication for 17-OHP, 580 (12.8%) were prescribed 17-OHP. Regional and state-based differences in 17-OHP utilization were identified; Northeast 15.7%, Midwest 13.7%, South 12.0%, and West 10.4% (p=0.003).

Conclusions

While significant regional differences in 17-OHP utilization were demonstrated, 17-OHP utilization remained low despite this cohort having insurance through a US commercial managed care plan. Suboptimal utilization demonstrates a disconnect between research and uptake in clinical practice. This underscores a need for implementation science in obstetrics to translate updated recommendations more effectively and efficiently into clinical practice.

Keywords: 17α-hydroxyprogesterone caproate; 17-OHP; regional variation; utilization
Corresponding author: Jessica M. Hart, MD, Assistant professor, Department of Maternal-Fetal Medicine, University of Connecticut School of Medicine, Hartford HealthCare, 85 Jefferson Street 06102, Hartford, CT, USA, Phone: 860-978-3193, E-mail:

Funding source: National Heart, Lung, and Blood Institute

Award Identifier / Grant number: 5K01HL141771

  1. Research funding: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication. Dr. Beam was supported by a K01 grant from the NHLBI (award number 5K01HL141771).

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Dr. Wylie serves as a Board Member for the Society of Maternal Fetal Medicine. All other authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: The Harvard Institutional Review Board waived the requirement for approval, as it deemed this analysis of the database to not be human subjects research.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2021-0586).

Received: 2021-11-09
Accepted: 2022-05-12
Published Online: 2022-06-03
Published in Print: 2022-11-25

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

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  2. Review
  3. Obstetric hemorrhage: effective methods for addressing the menace in Sub-Saharan Africa
  4. Mini Review
  5. The use of neurally-adjusted ventilatory assist (NAVA) for infants with congenital diaphragmatic hernia (CDH)
  6. Opinion Paper
  7. The role of specialist perinatal psychiatrists in modern medicine
  8. Corner of Academy
  9. Maternal perception of fetal movements: onset and associated factors
  10. Original Articles – Obstetrics
  11. Cervical ripening as an outpatient procedure in the pandemic – minimizing the inpatient days and lowering the socioeconomic costs
  12. Can sonographic imaging of the fetal pancreas predict perinatal outcomes in gestational diabetes mellitus?
  13. Comparison of transvaginal sonographic cervical length measurement and Bishop score for predicting labour induction outcomes
  14. Regional differences in utilization of 17α-hydroxyprogesterone caproate (17-OHP)
  15. Effect of anesthesia selection on neonatal outcomes in cesarean hysterectomies for placenta accreta spectrum (PAS)
  16. Bile-acid levels and lung maturity test in patients with intrahepatic cholestasis of pregnancy
  17. Evaluation of appropriate vancomycin prescribing for the prevention of newborn group B streptococcal infections in a community hospital obstetrics service
  18. Effect of supplementation with 5,000 IU of vitamin D on the glycemic profile of women with gestational diabetes mellitus
  19. Association of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms with vitamin B12 deficiency and adverse perinatal outcomes among pregnant women of rural South India – a cross sectional longitudinal study
  20. Original Article – Fetus
  21. Fetal autopsy for the diagnosis of skeletal dysplasia and comparison with prenatal ultrasound findings over a 16-year period
  22. Original Articles – Neonates
  23. Neonatal admission rate after vaginal breech delivery
  24. Extremely low gestational age neonates and resuscitation: survey on perspectives of Canadian neonatologists
  25. The effect of 150 and 80 mg doses of aspirin on preventing preterm birth in high-risk pregnant women
  26. Letters to the Editor
  27. Aspirin for the prevention of preeclampsia
  28. Reply to: Aspirin for the prevention of preeclampsia
  29. Total bile acid levels for clinically suspected intrahepatic cholestasis of pregnancy
  30. Reply: Neonatal lung injury with intrahepatic cholestasis of pregnancy
  31. Marijuana and pregnancy: just because its legal doesn’t make it safe
  32. Corrigenda
  33. Stillbirth aftercare in a tertiary obstetric center–parents’ experiences
  34. Prospective risk of stillbirth according to fetal size at term
https://doi.org/10.1515/jpm-2021-0586
Keywords for this article
17α-hydroxyprogesterone caproate; 17-OHP; regional variation; utilization

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Obstetric hemorrhage: effective methods for addressing the menace in Sub-Saharan Africa
  4. Mini Review
  5. The use of neurally-adjusted ventilatory assist (NAVA) for infants with congenital diaphragmatic hernia (CDH)
  6. Opinion Paper
  7. The role of specialist perinatal psychiatrists in modern medicine
  8. Corner of Academy
  9. Maternal perception of fetal movements: onset and associated factors
  10. Original Articles – Obstetrics
  11. Cervical ripening as an outpatient procedure in the pandemic – minimizing the inpatient days and lowering the socioeconomic costs
  12. Can sonographic imaging of the fetal pancreas predict perinatal outcomes in gestational diabetes mellitus?
  13. Comparison of transvaginal sonographic cervical length measurement and Bishop score for predicting labour induction outcomes
  14. Regional differences in utilization of 17α-hydroxyprogesterone caproate (17-OHP)
  15. Effect of anesthesia selection on neonatal outcomes in cesarean hysterectomies for placenta accreta spectrum (PAS)
  16. Bile-acid levels and lung maturity test in patients with intrahepatic cholestasis of pregnancy
  17. Evaluation of appropriate vancomycin prescribing for the prevention of newborn group B streptococcal infections in a community hospital obstetrics service
  18. Effect of supplementation with 5,000 IU of vitamin D on the glycemic profile of women with gestational diabetes mellitus
  19. Association of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms with vitamin B12 deficiency and adverse perinatal outcomes among pregnant women of rural South India – a cross sectional longitudinal study
  20. Original Article – Fetus
  21. Fetal autopsy for the diagnosis of skeletal dysplasia and comparison with prenatal ultrasound findings over a 16-year period
  22. Original Articles – Neonates
  23. Neonatal admission rate after vaginal breech delivery
  24. Extremely low gestational age neonates and resuscitation: survey on perspectives of Canadian neonatologists
  25. The effect of 150 and 80 mg doses of aspirin on preventing preterm birth in high-risk pregnant women
  26. Letters to the Editor
  27. Aspirin for the prevention of preeclampsia
  28. Reply to: Aspirin for the prevention of preeclampsia
  29. Total bile acid levels for clinically suspected intrahepatic cholestasis of pregnancy
  30. Reply: Neonatal lung injury with intrahepatic cholestasis of pregnancy
  31. Marijuana and pregnancy: just because its legal doesn’t make it safe
  32. Corrigenda
  33. Stillbirth aftercare in a tertiary obstetric center–parents’ experiences
  34. Prospective risk of stillbirth according to fetal size at term
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