Open AccessProgesterone supplementation for preventing preterm birth: a systematic review and meta‐analysis
Author(s) -
Dodd Jodie M.,
Crowther Caroline A.,
Cincotta Robert,
Flenady Vicki,
Robinson Jeffrey S.
Publication year - 2005
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.0001-6349.2005.00835.x
Subject(s) - medicine , meta analysis , obstetrics , systematic review , medline , gynecology , political science , law
Aim. The aim of this study is to assess the role of progesterone in preterm birth prevention. Methods. A MEDLINE search (from 1966 to the present; date of last search January 2005) was performed – using the key words progesterone, pregnancy, preterm birth, preterm labor, and randomized, controlled trial – in order to identify randomized, controlled trials in which progesterone (either intramuscular or vaginal administration) was compared with placebo or no treatment. Data were extracted and a meta‐analysis was performed. Results. Seven randomized, controlled trials were identified. Women who received progesterone were statistically significantly less likely to give birth before 37 weeks (seven studies, 1020 women, RR = 0.58, 95% CI = 0.48–0.70), to have an infant with birth weight of ≤2.5 kg (six studies, 872 infants, RR = 0.62, 95% CI = 0.49–0.78), or to have an infant diagnosed with intraventricular hemorrhage (one study, 458 infants, RR = 0.25, 95% CI = 0.08–0.82). Conclusions. For progesterone supplementation to be advocated for women at the risk of preterm birth, the prolongation of gestation demonstrated in this meta‐analysis must translate into improved infant outcomes, including a reduction in mortality. There is currently insufficient information to allow recommendations regarding the optimal dose, route, and timing of administration of progesterone supplementation.