Study looks at benefits of progestogens to prevent early childbirth

September 10, 2012

Pregnant women who have had prior preterm births may avoid a subsequent early birth if given progestogens, which are natural or synthetic forms of progesterone, a female hormone that naturally increases during pregnancy, a Vanderbilt analysis shows.

who have had prior preterm births and are given progestogens while expecting a single child show some benefit from additional hormone, Vanderbilt researchers reported in a systematic review released on Thursday in & Gynecology, the official publication of the American College of Obstetricians and Gynecologists, commonly referred to as The Green Journal.

The researchers looked at 34 prior studies of women who were given progestogens for prior preterm births, multiple gestations, preterm labor, short cervix or other indications. Each study included 20 or more women who were given the medication by injection, orally or vaginally, and took place between January 1966 and October 2011.

The work was funded by the Agency for Healthcare Research and Quality (AHRQ).

In contrast, the researchers found progestogens don't seem to help prevent preterm labor in women carrying twins or triplets. And evidence supporting giving progestogens for all other uses is insufficient to guide clinical care.

The review provides valuable information, but more study is needed, said Frances E. Likis, DrPH, N.P., CNM, research assistant professor of Medicine and the lead author of the review. "While we know that women have levels that go up in early and remain elevated, we still don't understand why giving extra progestogens would help them stay pregnant," she said. "The pharmaceutical effects are not well understood."

The United States has a very high rate and was among the top 10 countries with the highest numbers of preterm births in 2010. "We haven't been able to move that number very well, and although it's gone down somewhat in past years, it's not a dramatic drop," she said.

Along with the systematic review, the AHRQ is releasing Vanderbilt's longer report on progestogens for preterm birth prevention online today. The full report looks at other questions such as whether how progestogens are administered makes a difference in effectiveness and the adverse effects of progestogens for preterm birth.

Progestogens are usually given by clinicians to women at the beginning of the second trimester through 37 weeks gestation or until the baby is born. Most women receive the medication once a week by injection, although some receive it vaginally. Very few take an oral dose.

Likis said asking generally whether progestogens are beneficial isn't possible. "Women are being given progestogens for very different reasons, so in our review, we decided to look at effectiveness by why women took it. Having had a previous preterm birth is different from having twins, and that's how clinicians make decisions. They don't just look at women and say 'you're at risk,' they say 'what is your risk factor?'"

To look at complications, a larger group of women is needed, she said. "There's relatively little evidence about whether babies had complications, and there's also very little information about long-term health effects in the infant," she said. "There's a lot more that needs to be studied. There's a lot of work to be done."

Explore further: Study finds residence in US a risk factor for preterm birth

More information: The full report can be viewed at www.ahrq.gov

Related Stories

Study finds residence in US a risk factor for preterm birth

February 9, 2012
In a study to be presented today at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, in Dallas, Texas, researchers will report findings that indicate that duration of stay in the United States ...

Vaginal progesterone reduces preterm birth, neonatal morbidity and mortality in women at risk

December 14, 2011
Women with a short cervix should be treated with vaginal progesterone to prevent preterm birth, according to a landmark study by leading obstetricians around the world. Vaginal progesterone decreased the rate of preterm birth ...

Progesterone reduces rate of early preterm birth in at-risk women

April 6, 2011
A National Institutes of Health study has found that progesterone, a naturally occurring hormone, reduced the rate of preterm birth before the 33rd week of pregnancy by 45 percent among one category of at risk women.

Antidepressants -- not depression -- increase risk of preterm birth, study shows

May 28, 2012
(Medical Xpress) -- Women who are depressed during pregnancy are not at higher risk of giving birth prematurely than non-depressed women — but those who take antidepressants during pregnancy seem to be, a new study ...

Recommended for you

Hope for couples suffering IVF miscarriage

September 20, 2017
Women who miscarry during their first full round of IVF are more likely to have a baby after further treatment than women who don't get pregnant at all.

Does mother's mental health affect pregnancy?

September 13, 2017
(HealthDay)—Three common mental health disorders—depression, panic disorder and generalized anxiety disorder—pose no serious threat to pregnant women or the health of their babies, a new study finds.

Preeclampsia may boost heart disease risk by altering blood vessels

September 12, 2017
Preeclampsia may permanently change the blood vessels of women who experience the condition during pregnancy, boosting their lifelong risk for cardiovascular disease, according to Penn State researchers.

Discovery of genes linked to preterm birth in landmark study

September 6, 2017
A massive DNA analysis of pregnant women has identified six gene regions that influence the length of pregnancy and the timing of birth. The findings, published today in the New England Journal of Medicine, may lead to new ...

Older wombs linked to complications in pregnant mice

September 5, 2017
Deciding to start a family later in life could be about more than just the age of your eggs. A new study in mice suggests the age of a mother's womb may also have a part to play. This work, led by Dr Myriam Hemberger at the ...

Study suggests simple way to predict preterm births

September 4, 2017
Up to 18 percent of babies born worldwide arrive before they are full-term, defined as 37 weeks of gestation. About 1 million of those babies do not survive, and those who do can face developmental problems such as impaired ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.