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Progesterone, whether administered intramuscularly or vaginally, does not lower the risk of recurrent spontaneous preterm birth before 34 or 37 weeks’ gestation in women with a singleton pregnancy and a history of preterm birth.
Prevention of preterm birth is a pressing issue which is associated with infant illness and death globally. Published in BMC Pregnancy and Childbirth, this retrospective cohort study aimed to assess the effectiveness of progesterone therapy, including intramuscular administration of 17-α-hydroxyprogesterone caproate and vaginal progesterone, in preventing the occurrence of recurring spontaneous preterm birth (PTB) before 37 and 34 weeks’ gestation.
This study was conducted involving 637 pregnant patients. Researchers compared the frequency of spontaneous PTB in progesterone-treated groups to those who received no treatment, utilizing Pearson chi-squared tests and independent t-tests for categorical and continuous variables. The study found that recurrent spontaneous PTB before 37 weeks occurred in 22.3% of the no-treatment group, 29.1% of the 17-α-hydroxyprogesterone caproate group, and 14.3% of the vaginal progesterone group. For spontaneous PTB before 34 weeks, the rates were 6.6% in the no-treatment group, 11.8% in the 17-OHPC group, and 7.1% in the vaginal progesterone group. Neither form of progesterone therapy showed a noteworthy decrease in recurring spontaneous PTB at any gestational age. Furthermore, for participants with a short cervix, IM 17-α-hydroxyprogesterone caproate was related to an augmented risk of recurrent spontaneous PTB before 37 weeks.
As concluded, these findings suggest progesterone therapy does not significantly lower the risk of recurrent preterm births, calling into question its efficacy as a preventive measure.
BMC Pregnancy and Childbirth
Progesterone therapy for prevention of recurrent spontaneous preterm birth in a minority patient population: a retrospective study
Genevieve R. Mazza et al.
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