Humana Offers Pregnancy Prolongation Program

Humana and its program vendor, Alere Women’s and Children’s Health (formerly Matria), are offering a 17 hydroxyprogesterone (17P) Pregnancy Support Program to Humana-insured pregnant women who have a history of spontaneous preterm delivery at less than 37 weeks of gestation.

In the May 2005 edition of Obstetrics and Gynecology, a Clinical Expert Series article, “17 Hydroxyprogesterone for the Prevention of Preterm Delivery,”¹ further confirmed the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion #291², use of progesterone to reduce preterm birth:

“Recent studies support the hypothesis that progesterone supplementation reduces preterm birth in a select group of women (i.e, those with a prior spontaneous birth at less than 37 weeks of gestation).”

The National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network study, reported by Meis, et.al., in the New England Journal of Medicine (NEJM), June 12, 2003³, is the largest study on the use of progestational agents to prevent preterm birth and immediately preceded the creation of the ACOG Committee Opinion. In addition, there also has been a review of “Progestational Agents to Prevent Preterm Birth” in the February 2005 edition of Obstetrics and Gynecology⁴. The eligibility criteria for the study by Meis, et.al., included a current pregnancy between 16 – 20 weeks, emphasizing the further importance of women receiving prenatal care in the first trimester. ⁵

The Pregnancy Prolongation Program gives women who have experienced premature delivery the opportunity to receive 17P injections. Once referred into the program, each member will have an obstetrics (OB) nurse assigned to her, starting during the 16th week of pregnancy. The 17P injections are given weekly at home or at work, whichever is more comfortable and convenient. In addition to the weekly visits with their OB nurse, enrollees receive 24 hours a day, seven days a week access to nursing support via telephone. The program also benefits physicians, as it helps increase patient compliance and patient satisfaction, as well as streamlined office efficiency.

Humana encourages physicians to refer Humana-insured women who have experienced premature delivery and could benefit from 17P to the program. For more information on the program, visit Alere.com or http://www.humana.com/members/health/humana_beginnings.asp.

Humana also would like to remind physicians and office staffs about the HumanaBeginnings prenatal program, which offers additional support and education to pregnant Humana members. The HumanaBeginnings program includes:

• Confidential pregnancy assessments that provide customized education, guidance and support to meet patients’ individual needs
  
• The members’ choice of a pregnancy or childbirth book or DVD
  
• Monthly outreach calls by experienced OB nurses throughout the members’ pregnancies adjusted to meet the women’s schedule and increased in frequency for high risk conditions

Physician support of the HumanaBeginnings prenatal program goes a long way in promoting patients’ healthy pregnancy outcomes. “The clinical guidance team at Humana is excited to collaborate with Alere, HumanaBeginnings and our community obstetricians by promoting the pregnancy prolongation program. Premature delivery is a devastating medical problem that exacts a huge emotional and economic toll on patients. Finally, we can have a significant positive impact on the women who have a history of premature spontaneous delivery,” said John Knispel, M.D., CPE, FACOG, regional medical director for Humana Florida commercial markets.

For more information about the HumanaBeginnings Prenatal Program, visit http://www.humana.com/members/health/humana_beginnings.asp.


1 Meis P for the Society for Maternal–Fetal Medicine; 17 Hydroxyprogesterone for the Prevention of Preterm Delivery. Obstet Gynecol 2005;105:1128 –35.
2 Use of progesterone to reduce preterm birth. ACOG Committee Opinion No. 291. American College of Obstetricians and Gynecologists. Obstet Gynecol 2003;102:1115– 6.
3 Meis P, Klebanoff M, Thom E, Dombrowski MP, Sibai B, Moawad AH, et al.; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Prevention of recurrent preterm delivery by 17 alphahydroxyprogesterone caproate (published erratum appears in N Engl J Med. 2003;349:1299). N Engl J Med 2003;348: 2379–85.
4 Luis Sanchez-Ramos, MD, Andrew M. Kaunitz, MD, and Isaac Delke, MD. Progestational Agents to Prevent Preterm Birth: A Meta-Analysis of Randomized Controlled Trials. Obstet Gynecol 2005;105:273–9.
5 Joann R. Petrini, PhD, MPH, William M. Callaghan, MD, MPH, Mark Klebanoff, MD, MPH, Nancy S. Green, MD, Eve M. Lackritz, MD, Jennifer L. Howse, PhD, Richard H. Schwarz, MD, and Karla Damus, RN, PhD. Estimated Effect of 17 Alpha-Hydroxyprogesterone Caproate on Preterm Birth in the United States. Obstet Gynecol 2005;105:267–72.

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