Kara Hoppe, DO, MS; Renee D. Kramer, MPH; Barbara Ha, MPH; Angela Rohan, PhD; Chelsea Aeschbach, MPH; Deborah B. Ehrenthal, MD, MPH
Objective: To assess provider practice patterns on type of progesterone prescribed and barriers specific to 17 α-hydroxyprogesterone caproate utilization for preterm birth prevention.
Study Design: A survey mailed to providers assessed utilization and barriers to long-acting reversible contraception and progesterone for preterm birth prevention. Data analysis included chi-square tests for homogeneity followed by post hoc tests of proportions to detect significant pairwise differences.
Results: Five hundred sixty-three of 1,695 respondents who provide prenatal care were included in the analysis. More obstetric than family medicine and midwife providers (87.4% vs 31.4% and 72.6%, respectively; P < .001) prescribed any progesterone for preterm birth prevention. More obstetric providers prescribed 17 α-hydroxyprogesterone caproate (17OHP-C) compared with family medicine and midwife providers (98.1% vs 77.8% and 80.5%, respectively; P < .0001). Family medicine and midwife providers prescribed oral progestertone more often than obstetric providers (40.7% and 24.4% vs 13.1%; P < .05). System-level barriers to 17OHP-C were reported more often than patientlevel barriers at a rate that was highest among family medicine and midwife providers.
Conclusion: 17OHP-C has been demonstrated to be an effective method for prevention of recurrent preterm birth. It is used significantly less—and oral progesterone is used significantly more—by family medicine and midwife providers, emphasizing the need for increased education and decreased treatment barriers for its utilization for preterm birth prevention.