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Progesterone supplementation for preventing preterm birth: a systematic review and meta-analysis
Jodie M Dodd1, Caroline A Crowther, Robert Cincotta
1Department of Obstetrics and Gynaecology, The University of Adelaide, Australia. jodie.dodd@adelaide.edu.au
Acta Obstetricia Et Gynecologica Scandinavica
|May 20, 2005
Summary
Progesterone supplementation significantly reduces the risk of preterm birth and low birth weight infants. Further research is needed to establish optimal dosage and administration for improved infant outcomes.
Area of Science:
- Obstetrics and Gynecology
- Perinatology
- Pharmacology
Background:
- Preterm birth is a significant cause of neonatal morbidity and mortality.
- Progesterone has been investigated for its potential role in preventing preterm birth.
- Identifying effective interventions for preterm birth prevention is a critical area of research.
Purpose of the Study:
- To assess the efficacy of progesterone in preventing preterm birth.
- To evaluate the impact of progesterone on infant birth weight and intraventricular hemorrhage.
Main Methods:
- A comprehensive literature search was conducted using MEDLINE from 1966 to January 2005.
- Keywords included progesterone, pregnancy, preterm birth, preterm labor, and randomized controlled trial.
- A meta-analysis of seven identified randomized controlled trials comparing progesterone with placebo or no treatment was performed.
Main Results:
- Progesterone administration was associated with a statistically significant reduction in births before 37 weeks gestation (RR = 0.58).
- Infants born to mothers receiving progesterone had a significantly lower risk of birth weight less than or equal to 2.5 kg (RR = 0.62).
- A significant reduction in the incidence of intraventricular hemorrhage was observed in infants whose mothers received progesterone (RR = 0.25).
Conclusions:
- Progesterone supplementation shows promise in prolonging gestation and potentially improving infant outcomes.
- Translating the demonstrated prolongation of gestation into reduced infant mortality requires further investigation.
- Current data are insufficient to provide recommendations on optimal progesterone dosage, route, or timing of administration.