Prenatal administration of progesterone for preventing preterm birth in women considered to be at risk of preterm birth.

@article{Dodd2013PrenatalAO,
  title={Prenatal administration of progesterone for preventing preterm birth in women considered to be at risk of preterm birth.},
  author={Jodie M. Dodd and Leanne V Jones and Vicki J. Flenady and Rob Cincotta and Caroline A. Crowther},
  journal={The Cochrane database of systematic reviews},
  year={2013},
  volume={7},
  pages={
          CD004947
        }
}
BACKGROUND Preterm birth is a major complication of pregnancy associated with perinatal mortality and morbidity. [] Key MethodWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (14 January 2013) and reviewed the reference list of all articles. SELECTION CRITERIA Randomised controlled trials, in which progesterone was given for preventing preterm birth.

Figures from this paper

Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.

The incidence of perinatal death in the progesterone group was higher, although there was considerable uncertainty around the effect estimate and high heterogeneity between studies, and the CIs crossed the line of no effect.

Does prophylactic progesterone for women at high risk of preterm birth improve outcomes?

  • Dtb selecT
  • Medicine
    Drug and Therapeutics Bulletin
  • 2019
Progesterone treatment had no effect compared with placebo on the obstetric outcomes, neonatal outcomes, Neonatal outcomes or childhood outcomes (the Bayley-iii cognitive composite score at 22–26 months of age).

Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.

Although the incidence of perinatal death in the progesterone group was higher, there was considerable uncertainty around the effect estimate and high heterogeneity between studies, and there were no clear group differences found in any of the other maternal or infant outcomes.

Progesterone for the Prevention of Preterm Birth

Vaginal progesterone has been found to reduce preterm birth in women with a foreshortened cervix as measured by transvaginal ultrasonography, but there is unfortunately no evidence whatsoever that progester one reduces pre term birth among women with multiple gestations.

Prophylactic oral betamimetics for reducing preterm birth in women with a twin pregnancy.

The quality of evidence is low for the primary outcomes and the effectiveness of prophylactic oral betamimetics for the prevention of preterm labour and birth for women with twin pregnancies is unproven.

Neonatal outcome in women receiving vaginal progesterone for prevention of preterm birth

There is some evidence that vaginal administration of progesterone in high-risk women for PTB starting in the second trimester and continued till 34 weeks can lower the PTB and improve the neonatal prognosis, without causing any adverse effect to the neonate.

Does progesterone prophylaxis to prevent preterm labour improve outcome? A randomised double-blind placebo-controlled trial (OPPTIMUM).

In this study, progesterone had no significant beneficial or harmful effects on the primary obstetric, neonatal or childhood outcomes.

Vaginal progesterone pessaries for pregnant women with a previous preterm birth to prevent neonatal respiratory distress syndrome (the PROGRESS Study): A multicentre, randomised, placebo-controlled trial

The results do not support the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth to reduce the risk and severity of respiratory distress syndrome in their infants.
...

References

SHOWING 1-10 OF 171 REFERENCES

Prenatal administration of progesterone for preventing preterm birth.

Intramuscular progesterone is associated with a reduction in the risk of preterm birth less than 37 weeks' gestation, and infant birthweight less than 2500 grams.

Progesterone for the prevention of preterm birth in women with multiple pregnancies: the AMPHIA trial

This trial will provide evidence as to whether or not 17OHPC-treatment is an effective means of preventing bad neonatal outcome due to preterm birth in multiple pregnancies.

Progesterone effects on preterm birth in high-risk pregnancies: a randomized placebo-controlled trial

Prophylactic vaginal progesterone reduced the rate of preterm labor and preterm delivery in high-risk pregnancies and there was no significant difference in neonatal death between placebo and progester one groups.

Preventing preterm birth with progesterone: costs and effects of screening low risk women with a singleton pregnancy for short cervical length, the Triple P study

This study will provide evidence for the usefulness and cost-effectiveness of screening for short cervical length at the 18-22 weeks and subsequent progesterone treatment among low risk women.

Trial protocol OPPTIMUM– Does progesterone prophylaxis for the prevention of preterm labour improve outcome?

The OPPTIMUM study is a double blind randomized placebo controlled trial to determine whether progesterone prophylaxis to prevent preterm birth has long term neonatal or infant benefit.

Progesterone and the risk of preterm birth among women with a short cervix.

In women with a short cervix, treatment with progesterone reduces the rate of spontaneous early preterm delivery and is associated with a nonsignificant reduction in neonatal morbidity.

Study of progesterone for the prevention of preterm birth in twins (STOPPIT): Findings from a trial-based cost-effectiveness analysis

There is little economic justification for conducting further research into the use of vaginal progesterone gel in twin pregnancies for the prevention of preterm birth, given the scale of the clinical and economic burden of this condition.

Progestogens to prevent preterm birth in twin pregnancies: an individual participant data meta-analysis of randomized trials

Combining individual patient data from different randomized trials has potential to provide valuable, clinically useful information regarding the benefits and potential harms of progestogens in women with twin pregnancy overall and in relevant subgroups.
...