Prevention of Preterm Birth with Progesterone

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Perinatal Health

Background:

• Preterm birth (PTB) is a leading cause of infant morbidity and mortality, affecting approximately 11% of births globally.
• The mechanisms underlying premature labor activation are complex, multifactorial, and involve inflammatory pathways.
• Early detection and prevention strategies are crucial for improving perinatal outcomes.

Purpose of the Study:

• To review the role of progesterone in the prevention of preterm birth.
• To discuss the known mechanisms by which progesterone exerts its preventive effects.
• To address current debates regarding progesterone use in multifetal gestations.

Main Methods:

• Literature review of scientific knowledge, data, and recommendations on progesterone for PTB prevention.
• Analysis of progesterone's effects on prostaglandin synthesis, cervical stroma, inflammation, gap junctions, and myometrial activity.
• Examination of evidence concerning progesterone formulations, doses, administration routes, and safety in multifetal pregnancies.

Main Results:

• Progesterone demonstrates beneficial effects in PTB prevention, including reduced prostaglandin synthesis and cervical degradation.
• It modulates inflammatory responses, decreases gap junction formation, and inhibits myometrial activation.
• Evidence supports progesterone's role, but optimal use in multifetal gestations remains under discussion.

Conclusions:

• Progesterone is a key factor in preventing preterm birth through multiple physiological mechanisms.
• Further research and clinical consensus are needed regarding its application in multifetal pregnancies.
• Optimizing progesterone therapy is essential for reducing the global burden of preterm birth.