• Elizabeth M Stringer, Catherine J Vladutiu, Priya Batra, Stringer Jeffrey S A JSA, and M Kathryn Menard.
• Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, California; and the Robert Wood Johnson Foundation, Princeton, New Jersey.
• Obstet Gynecol. 2016 Dec 1; 128 (6): 1397-1402.

AbstractEach year in the United States, more than 500,000 neonates are born before 37 weeks of gestation. Women who have experienced a previous preterm birth are at high risk of recurrence. A weekly prenatal injection of 17α-hydroxyprogesterone caproate decreases the risk of recurrent preterm birth and is recommended from as early as 16 weeks of gestation in women carrying singleton pregnancies who have a history of spontaneous singleton preterm birth. A commonly used metric for public health program effectiveness is population coverage of an intervention. In the case of 17α-hydroxyprogesterone caproate, population coverage can be defined as the proportion of women who are eligible for 17α-hydroxyprogesterone caproate (ie, previous pregnancy complicated by spontaneous singleton preterm birth) who actually receive the intervention. To receive a full course of 17α-hydroxyprogesterone caproate, women must negotiate a complex series of steps that includes presenting early for prenatal care, being identified as eligible for 17α-hydroxyprogesterone caproate, being offered 17α-hydroxyprogesterone caproate, accepting 17α-hydroxyprogesterone caproate, and adhering to the weekly 17α-hydroxyprogesterone caproate dose schedule. We describe this series of steps as well potential solutions to increase 17α-hydroxyprogesterone caproate coverage.

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