/ /

  • linkedin
  • Increase Font
  • Sharebar

    Does early menstruation increase risk of GDM?


    Can vaginal progesterone reduce PTB in women with twins?

    According to a meta-analysis published in Ultrasound in Obstetrics & Gynecology, using vaginal progesterone may reduce the risk of preterm birth.

    Researchers searched Google Scholar, research registers of ongoing trials, MEDLINE, EMBASE, POPLINE, CINAHL, LILACS, and the Cochrane Central Register to look for randomized controlled trials (RCTs) which compared vaginal progesterone with placebo/no treatment in women with a twin gestation and a mid-trimester sonographic cervical length ≤ 25mm and that had individual patient data. Primary measured outcome was preterm birth < 33 weeks’ gestation. Two reviewers selected the studies independently, assessed the risk of bias and extracted the data. They found data for 303 women (159 assigned to vaginal progesterone and 144 assigned to placebo/no treatment) and their 606 fetuses/infants from 6 RCTs. One study provided 74% of the total sample size.

    When compared with placebo or no treatment, vaginal progesterone was linked with a statistically significant reduction in the risk of preterm birth at < 33 weeks’ gestation (31.4% vs 43.1%; relative risk [RR], 0.69 [95% confidence interval {CI}, 0.51–0.93]; moderate-quality evidence). It was also linked with significant decrease in birth weight < 1500 g (RR, 0.53 [95% CI, 0.35–0.80]), neonatal death (RR, 0.53 [95% CI, 0.35–0.81]), preterm birth < 35, < 34, < 32 and < 30 weeks' gestation (RRs ranging from 0.47 to 0.83), composite neonatal morbidity and mortality (RR, 0.61 [95% CI, 0.34–0.98]), use of mechanical ventilation (RR, 0.54 [95% CI, 0.36–0.81]), and respiratory distress syndrome (RR, 0.70 [95% CI, 0.56–0.89]), all moderate evidence. Additionally, no significant difference was seen between vaginal progesterone and placebo groups in the neurodevelopmental outcomes for the children at 4 to 5 years of age.

    The researchers concluded that administering vaginal progesterone to mothers with twin gestation and a short cervix mid-trimester will reduce the risk of preterm vaginal birth, neonatal mortality, and some neonatal morbidities. The use of progesterone also appears to show no negative effects on the neurodevelopment of offspring.

    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available


    Latest Tweets Follow