17 alpha- Hydroxyprogesterone Caproate for the Prevention of Adverse Neonatal Outcome in Multiple Pregnancies: A Randomized Controlled Trial

摘要

In Reply: We thank Dr. O'Brien for his kind words on our article. We agree with him that a potentially harmful effect of 17alpha-hy-droxyprogesterone caproate treatment is a serious concern. Within our own trial, however, sample size was based on a composite measure of adverse neonatal outcome. All other findings, regardless of statistical significance, therefore should be interpreted with caution. In the Discussion of our article, we state that "the possibility that progesterone has a harmful effect on multiple pregnancies should not be ruled out based on lack of statistical significance." We stand by this statement and have initiated an individual participant data meta-analysis including all published and registered trials on progestogen treatment, both vaginal and 17alpha-hydroxypro-gesterone caproate, for the prevention of preterm birth in multiple pregnancies.