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Updated: Dec 6, 2025

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Preterm birth prevention.

Eduardo B da Fonseca1, Rievani Damião1, Daniela Aires Moreira2

  • 1Ob/Gyn Department, Federal University of Paraiba, João Pessoa, Paraiba, Brazil; Maternal Fetal Medicine Group, Nova Diagnóstico por Imagem, Brazil.

Best Practice & Research. Clinical Obstetrics & Gynaecology
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PubMed
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Prophylactic progesterone may reduce preterm birth rates in high-risk pregnancies. This review summarizes evidence on progesterone

Keywords:
Preterm birthProgesteroneShort cervical lengthTransvaginal ultrasound

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Endocrinology

Background:

  • Preterm birth (PTB) affects 12% of global pregnancies, causing significant neonatal morbidity and mortality.
  • Current symptomatic treatments (corticosteroids, antibiotics) improve neonatal outcomes but do not decrease PTB incidence.
  • Prophylactic progesterone is a potential strategy to reduce PTB rates.

Purpose of the Study:

  • To review the evidence supporting the prophylactic use of progesterone for reducing preterm birth.
  • To evaluate the effectiveness of progesterone in women with a history of PTB or short cervical length.

Main Methods:

  • Systematic review of Level A evidence.
  • Analysis of studies investigating progesterone's impact on PTB rates.
  • Focus on specific high-risk populations (prior PTB, short cervix).

Main Results:

  • Summarizes Level A evidence on progesterone's effectiveness.
  • Highlights potential reduction in PTB rates with prophylactic use.
  • Identifies specific patient groups who may benefit most.

Conclusions:

  • Prophylactic progesterone shows promise in reducing preterm birth.
  • Evidence supports its use in women with prior PTB or short cervix.
  • Further research may refine optimal protocols and patient selection.