Vaginal Progesterone Not Tied to Reduction in Recurrent Preterm Birth

Results do not appear to be influenced by adherence to vaginal progesterone

(HealthDay News) — Use of vaginal progesterone is not associated with a reduction in recurrent preterm birth, according to a study published online Oct. 31 in JAMA Network Open.

David B. Nelson, MD, from the University of Texas Southwestern Medical Center at Dallas, and colleagues evaluated the association of vaginal progesterone treatment with prevention of recurrent preterm birth among patients with a singleton pregnancy. The analysis included 417 patients who initiated treatment between 16 weeks and 0 days and 20 weeks and 6 days of pregnancy until 36 weeks and 6 days of pregnancy or delivery and matched (3:1) untreated historical controls.

The researchers found that the overall rate of recurrent preterm birth was 24.0% for the progesterone cohort vs 16.8% expected in the matched historical controls. There was no association observed between progesterone adherence and lower rates of recurrent preterm birth. There was a 0.2-week mean difference noted between historical matched controls and those using vaginal progesterone, without improvement in the interval of recurrent preterm birth. There was no difference seen in progesterone blood levels for adherent vs nonadherent patients at either 24 or 32 weeks.

“Because of the controversy around injectable progesterone, professional organizations pivoted and began to recommend vaginal progesterone,” Nelson said in a statement. “Everybody hoped this was the answer to reduce preterm births and there’s been enthusiasm that it may show a benefit.”

Abstract/Full Text