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The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo
Published on: August 2, 2017
Progesterone in pregnancy and neonatal outcomes: A systematic review and meta-analysis of randomized controlled
Matheus Fernandes Dias1, Manuel Do O De Souto Neto1, Heitor Alves Duarte1
1Multicampi School of Medical Sciences of Rio Grande Do Norte, Federal University of Rio Grande Do Norte, Caicó, Brazil.
Background:
Given the significant morbidity associated with premature neonates, the use of progesterone to prolong pregnancy has emerged as a promising intervention to mitigate this condition. A comprehensive understanding of the benefits and potential risks of progesterone therapy enables healthcare providers to develop targeted strategies aimed at improving perinatal outcomes. By optimizing the use of this treatment, we can promote safer and more effective interventions, ultimately enhancing the health and well-being of both mothers and infants.
Objective:
The aim of this study was to evaluate the safety and efficacy of progesterone therapy in neonates.
Search Strategy:
A systematic review with meta-analysis was performed using the electronic databases Cochrane Central, Embase, and PubMed, searching the following terms "pregnancy prolongation" and "vaginal progesterone" or "17-α-hydroxyprogesteron".
Selection Criteria:
Randomized clinical trials were investigated to compare the use of progesterone with placebo or no intervention to prolong pregnancy and reporting neonatal outcomes.
Data Collection And Analysis:
The authors independently reviewed the titles, abstracts, and full texts based on predefined inclusion and exclusion criteria, resolving any discrepancies through discussion. Data extraction and methodological quality assessment were conducted by each author using a standardized approach. Ten outcomes were assessed. The meta-analysis calculations were performed using the meta package in Rstudio, version 4.2.2 (R Foundation for Statistical Computing).
Main Results:
We included 12 randomized studies with 1557 participants, of whom 888 (57.3%) were randomized to receive progesterone therapy. Neonates in the progesterone group had a lower risk of respiratory distress syndrome (risk ratio [RR], 0.61 [95% confidence interval (CI), 0.43-0.87], P < 0.01), sepsis (RR, 0.51 [95% CI, 0.27-0.96], P = 0.039), pneumonia (RR, 0.29 [95% CI, 0.11-0.74], P < 0.01), retinopathy (RR, 0.38 [95% CI, 0.17-0.83], P = 0.015), and ventilatory assistance (RR, 0.65 [95% CI, 0.46-0.91], P = 0.012).
Conclusion:
Our study was able to demonstrate the benefit of progesterone in significantly reducing the risk of adverse neonatal outcomes.
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