Progesterone may reduce recurrent preemie risk
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For women who have had a previous preterm delivery, treatment with a synthetic version of the female hormone progesterone appears to reduce the risk of subsequent preterm birth, researchers report.
“While this treatment applies at this time to a limited number of women,” said Dr. Paul J. Meis, “it represents a hopeful start, the first effective method to reduce the chance of preterm delivery for women at risk for this problem.”
Meis, at Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues note in the medical journal Obstetrics and Gynecology that the rate of preterm births in the US has been increasing, and among the strongest predictive factors is a previous history of a preterm delivery.
To gain further information, the researchers conducted a secondary analysis of data from a trial of progesterone treatment in 463 women who had had at least one previous spontaneous preterm delivery. In all, 310 were randomly assigned to an active treatment group and 153 to inactive “placebo” treatment.
The original study results showed a reduction in preterm delivery from 55 percent in the placebo group to 36 percent in the treatment group.
In the current analysis, the researchers found that in both groups the number of previous preterm deliveries and whether the penultimate delivery was preterm were significant risk factors.
Their calculations also showed that progesterone treatment canceled out the risk associated with more than one previous preterm delivery, but not the risk associated with a penultimate preterm Pregnancy.
The investigators conclude that preterm birth probably has many causes and that recurrent preterm deliveries may be “related to a problem for which progesterone treatment is particularly efficacious.”
SOURCE: Obstetrics and Gynecology, September 2005.
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