Progesterone Supplementation for the Prevention of Preterm Birth: Provider Practice in Wisconsin.

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 17a-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 patient-level 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.