The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
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Ki Hoon Ahn
, Ji-Sung Lee
Abstract
Background:
The safety of preventive progestogen therapy for preterm birth remains to be established. This meta-analysis aimed to evaluate the effects of preventive progestogen therapy on neonatal mortality.
Methods:
Randomized controlled trials (RCTs) on the preventive use of progestogen therapy, published between October 1971 and November 2015, were identified by searching MEDLINE/PubMed, EMBASE, Scopus, ClinicalTrials.gov, Cochrane Library databases, CINAHL, POPLINE, and LILACS using “progesterone” and “preterm birth” as key terms. We conducted separate analyses according to the type of progestogen administered and plurality of the pregnancy.
Results:
Twenty-two RCTs provided data on 11,188 neonates. Preventive progestogen treatment in women with a history of preterm birth or short cervical length was not associated with increased risk of neonatal death compared to placebo in all analyzed progestogen types and pregnancy conditions. The pooled relative risks (95% confidence interval) of neonatal mortality were 0.69 (0.31–1.54) for vaginal progestogen in singleton pregnancies, 0.6 (0.33–1.09) for intramuscular progestogen in singleton pregnancies, 0.96 (0.51–1.8) for vaginal progestogen in multiple pregnancies, and 0.96 (0.49–1.9) for intramuscular progestogen in multiple pregnancies.
Conclusions:
The results of this meta-analysis suggest that administration of preventive progestogen treatment to women at risk for preterm birth does not appear to negatively affect neonatal mortality in single or multiple pregnancies regardless of the route of administration.
Funding source: College of Medicine, Korea University
Award Identifier / Grant number: K1421631
Funding statement: This study was supported by grant No. K1421631 from the Korea University College of Medicine, Seoul, South Korea. We have no conflict of interest for this study.
Acknowledgments:
This study was supported by grant No. K1421631 from the Korea University College of Medicine, Seoul, South Korea. We have no conflict of interest for this study.
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- What’s new in preterm birth prediction and prevention?
- Academy’s Corner
- Antenatal corticosteroids: current controversies
- Review articles
- The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
- Cervical pessary for the prevention of preterm birth: is it of any use?
- Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
- Highlight articles
- Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
- Nifedipine increases fetoplacental perfusion
- Effect of sleep disorders on threatened premature delivery
- Risk of recurrent preterm birth among women according to change in partner
- Biomarkers of spontaneous preterm birth: a systematic review of studies using multiplex analysis
- Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study
- Evaluation of quantitative fFn test in predicting the risk of preterm birth
- The value of ultrasound measurement of cervical length and parity in prediction of cesarean section risk in term premature rupture of membranes and unfavorable cervix
- Comparison of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and traditional clinical assessment for diagnosing premature rupture of fetal membranes
- Efficacy of a prospective community-based intervention to prevent preterm birth
- Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
- The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
- Thyroid dysfunction in preterm neonates exposed to iodine
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Editorial
- What’s new in preterm birth prediction and prevention?
- Academy’s Corner
- Antenatal corticosteroids: current controversies
- Review articles
- The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
- Cervical pessary for the prevention of preterm birth: is it of any use?
- Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
- Highlight articles
- Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
- Nifedipine increases fetoplacental perfusion
- Effect of sleep disorders on threatened premature delivery
- Risk of recurrent preterm birth among women according to change in partner
- Biomarkers of spontaneous preterm birth: a systematic review of studies using multiplex analysis
- Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study
- Evaluation of quantitative fFn test in predicting the risk of preterm birth
- The value of ultrasound measurement of cervical length and parity in prediction of cesarean section risk in term premature rupture of membranes and unfavorable cervix
- Comparison of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and traditional clinical assessment for diagnosing premature rupture of fetal membranes
- Efficacy of a prospective community-based intervention to prevent preterm birth
- Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
- The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
- Thyroid dysfunction in preterm neonates exposed to iodine
- Congress Calendar
- Congress Calendar