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Published on: January 12, 2018
Progestogens for preterm birth prevention: a systematic review and meta-analysis
Frances E Likis1, Digna R Velez Edwards, Jeffrey C Andrews
1Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health, and the Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37203-1738, USA. frances.likis@vanderbilt.edu
Obstetrics and Gynecology
|September 8, 2012
Summary
Progestogens effectively prevent preterm birth in singleton pregnancies for women with a history of preterm birth. However, they are not effective for multiple gestations, and evidence for other uses is insufficient.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Evidence-Based Medicine
Background:
- Preterm birth remains a leading cause of neonatal morbidity and mortality.
- Progestogens are commonly used to prevent preterm birth, but their effectiveness varies by indication.
- Systematic review and meta-analysis are crucial for evaluating treatment efficacy.
Purpose of the Study:
- To systematically review the effectiveness of progestogens for preventing preterm birth.
- To analyze data from randomized controlled trials using Bayesian meta-analysis.
- To evaluate progestogen efficacy in diverse high-risk pregnancies.
Main Methods:
- Systematic literature search of MEDLINE and EMBASE (1966-2011).
- Inclusion of randomized controlled trials with at least 20 participants.
- Bayesian meta-analysis of data from 19 eligible publications.
Main Results:
- Progestogens reduced preterm birth by 22% (RR 0.78) and neonatal death by 42% (RR 0.58) in singleton pregnancies with prior preterm birth.
- No significant effect on prematurity or neonatal death was observed in multiple gestations.
- Limited evidence suggests potential benefits for preterm labor and short cervix indications.
Conclusions:
- Progestogens are effective for preventing preterm birth in singleton pregnancies with a history of preterm birth.
- Evidence does not support progestogen use for preventing preterm birth in multiple gestations.
- Insufficient evidence exists for other indications, highlighting a need for further research on long-term outcomes.
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