Use of progesterone to prevent preterm birth at a tertiary care center

To assess the prescription patterns of progesterone for the prevention of preterm birth in a tertiary center.

We examined electronic medical records for all women receiving care in the high risk obstetric clinics at a tertiary care center from July 2003 to June 2004. Demographic information, progesterone offers, progesterone therapy accepted and received, and barriers to receiving progesterone were collected. Women were placed into 1 of 4 categories: appropriate offer, appropriate nonoffer, inappropriate offer and inappropriate nonoffer.

Five hundred two patients sought prenatal care in the clinics during the study period. Of 143 women with a prior preterm birth, 60 (42%) were considered to be candidates for progesterone. Of these, 34 of 60 (57%) were offered progesterone therapy (appropriate offer). Of the 442 women who were not appropriate progesterone candidates, 9 (2%) were offered progesterone (inappropriate offer).

Our data suggest that a substantial proportion of eligible women are not being offered progesterone for the prevention of preterm birth. More data are needed regarding barriers to progesterone use and what programs may best influence physicians to use progesterone appropriately.