Progesterone and Preterm: Seventy Years of“Déjà Vu” or “Still To Be Seen”?

Authors


  • Marc Keirse is Professor of Obstetrics and Gynecology at Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia.

  • In the Literature
    COMMENTARY ON: da Fonseca EB, Bittar RE, Carvalho MH, Zugaib M. Prophylactic administration of progesterone by vaginal suppository to reduce the incidence of spontaneous preterm birth in women at increased risk: A randomized placebo-controlled double-blind study. Am J Obstet Gynecol 2003;188:419–424.

    Meis PJ, Klebanoff M, Thom E, Dombrowski MP, Sibai B, Moawad AH, Spong CY, Hauth JC, Miodovnik M, Varner MW, Leveno KJ, Caritis SN, Iams JD, Wapner RJ, Conway D, O’Sullivan MJ, Carpenter M, Mercer B, Ramin SM, Thorp JM, Peaceman AM, Gabbe S, for the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med 2003;348:2379–2385.

Marc J.N.C. Keirse, Professor and Head, Department of Obstetrics, Gynecology and Reproductive Medicine, Flinders University, Flinders Medical Centre, Bedford Park SA 5042, Australia.

Abstract

Abstract: Progestogens for the prevention of preterm birth have a long history. In 2003, two widely publicized double-blind trials, one of daily vaginal progesterone suppositories and the other of weekly intramuscular injections of 17alpha-hydroxyprogesterone, claimed that the treatments effectively reduce the incidence of preterm birth in women at risk of spontaneous preterm labor. Critical analysis of the reports provides no convincing evidence that either one of these treatments is worth pursuing outside the context of controlled research to determine, first, whether and, second, how the treatments might work.

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