The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study
ObjectiveTo assess the impact of progesterone treatment on maternal and neonatal outcomes in women with a history of preterm birth and short cervical length diagnosed after 24 weeks of gestation.MethodsA retrospective cohort study included women with a history of preterm birth and a transvaginal son...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1130942/full |
| _version_ | 1811161725265772544 |
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| author | Danielle Luxenbourg Shay Porat Roberto Romero Roberto Romero Roberto Romero Roberto Romero Roberto Romero Dror Raif Nesher Rani Haj Yahya Yishai Sompolinsky Hila Hochler Yossef Ezra Doron Kabiri |
| author_facet | Danielle Luxenbourg Shay Porat Roberto Romero Roberto Romero Roberto Romero Roberto Romero Roberto Romero Dror Raif Nesher Rani Haj Yahya Yishai Sompolinsky Hila Hochler Yossef Ezra Doron Kabiri |
| author_sort | Danielle Luxenbourg |
| collection | DOAJ |
| description | ObjectiveTo assess the impact of progesterone treatment on maternal and neonatal outcomes in women with a history of preterm birth and short cervical length diagnosed after 24 weeks of gestation.MethodsA retrospective cohort study included women with a history of preterm birth and a transvaginal sonographic cervical length measurement of ≤ 25 mm, diagnosed between 24+0 and 33+6 weeks of gestation. Exclusion criteria included prior progesterone treatment, cervical cerclage, or pessary. The study population was divided into the progesterone treatment group and the non-treatment group.ResultsThe study included 104 women, with 46.2% (48/104) receiving progesterone treatment and 53.8% (56/104) not receiving treatment. The rate of spontaneous preterm birth before 37 weeks of gestation was 43% (24/56) in the non-treatment group and 31% (15/48) in the progesterone treatment group (P = 0.14); the rate of spontaneous preterm birth before 34 weeks was 7% (4/56) in the non-treatment group and 0% (0/48) in the progesterone treatment group (P = 0.05). Progesterone treatment was associated with a significant decrease in neonatal intensive care unit admissions (OR 0.20, 95% CI 0.05–0.74) and in the neonatal hospitalization period (mean difference in days 2.43, 95% CI 0.44–4.42). The risk of recurrent spontaneous preterm birth was highest (71%) among women with two or more previous preterm deliveries who did not receive progesterone treatment, and lowest (24%) among women with one previous preterm delivery who received progesterone treatment.ConclusionProgesterone treatment was associated with a reduction in rates of spontaneous preterm birth before 34 weeks of gestation, neonatal intensive care unit admission, and neonatal length of stay in high-risk patients, even when initiated after 24 weeks of gestation. |
| first_indexed | 2024-04-10T06:19:02Z |
| format | Article |
| id | doaj.art-f8d95835cfdd43049967280dc28a1644 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-10T06:19:02Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-f8d95835cfdd43049967280dc28a16442023-03-02T05:20:03ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-03-011010.3389/fmed.2023.11309421130942The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort studyDanielle Luxenbourg0Shay Porat1Roberto Romero2Roberto Romero3Roberto Romero4Roberto Romero5Roberto Romero6Dror Raif Nesher7Rani Haj Yahya8Yishai Sompolinsky9Hila Hochler10Yossef Ezra11Doron Kabiri12Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelDepartment of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelPerinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, United StatesDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United StatesDepartment of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United StatesCenter for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, United StatesDetroit Medical Center, Detroit, MI, United StatesDepartment of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelDepartment of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelDepartment of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelDepartment of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelDepartment of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelDepartment of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelObjectiveTo assess the impact of progesterone treatment on maternal and neonatal outcomes in women with a history of preterm birth and short cervical length diagnosed after 24 weeks of gestation.MethodsA retrospective cohort study included women with a history of preterm birth and a transvaginal sonographic cervical length measurement of ≤ 25 mm, diagnosed between 24+0 and 33+6 weeks of gestation. Exclusion criteria included prior progesterone treatment, cervical cerclage, or pessary. The study population was divided into the progesterone treatment group and the non-treatment group.ResultsThe study included 104 women, with 46.2% (48/104) receiving progesterone treatment and 53.8% (56/104) not receiving treatment. The rate of spontaneous preterm birth before 37 weeks of gestation was 43% (24/56) in the non-treatment group and 31% (15/48) in the progesterone treatment group (P = 0.14); the rate of spontaneous preterm birth before 34 weeks was 7% (4/56) in the non-treatment group and 0% (0/48) in the progesterone treatment group (P = 0.05). Progesterone treatment was associated with a significant decrease in neonatal intensive care unit admissions (OR 0.20, 95% CI 0.05–0.74) and in the neonatal hospitalization period (mean difference in days 2.43, 95% CI 0.44–4.42). The risk of recurrent spontaneous preterm birth was highest (71%) among women with two or more previous preterm deliveries who did not receive progesterone treatment, and lowest (24%) among women with one previous preterm delivery who received progesterone treatment.ConclusionProgesterone treatment was associated with a reduction in rates of spontaneous preterm birth before 34 weeks of gestation, neonatal intensive care unit admission, and neonatal length of stay in high-risk patients, even when initiated after 24 weeks of gestation.https://www.frontiersin.org/articles/10.3389/fmed.2023.1130942/fulladmission to neonatal intensive care unitprematuritypreterm deliverypreterm laborprogesteroneprogestogen |
| spellingShingle | Danielle Luxenbourg Shay Porat Roberto Romero Roberto Romero Roberto Romero Roberto Romero Roberto Romero Dror Raif Nesher Rani Haj Yahya Yishai Sompolinsky Hila Hochler Yossef Ezra Doron Kabiri The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study Frontiers in Medicine admission to neonatal intensive care unit prematurity preterm delivery preterm labor progesterone progestogen |
| title | The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study |
| title_full | The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study |
| title_fullStr | The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study |
| title_full_unstemmed | The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study |
| title_short | The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study |
| title_sort | effectiveness of vaginal progesterone in reducing preterm birth in high risk patients diagnosed with short cervical length after 24 weeks a retrospective cohort study |
| topic | admission to neonatal intensive care unit prematurity preterm delivery preterm labor progesterone progestogen |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1130942/full |
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