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

OBJECTIVE: To 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. METHODS: A retrospective cohort study included women with a history of preterm birth and a transvagina...

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Autores principales: Luxenbourg, Danielle, Porat, Shay, Romero, Roberto, Raif Nesher, Dror, Haj Yahya, Rani, Sompolinsky, Yishai, Hochler, Hila, Ezra, Yossef, Kabiri, Doron
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017734/
https://www.ncbi.nlm.nih.gov/pubmed/36936220
http://dx.doi.org/10.3389/fmed.2023.1130942
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author Luxenbourg, Danielle
Porat, Shay
Romero, Roberto
Raif Nesher, Dror
Haj Yahya, Rani
Sompolinsky, Yishai
Hochler, Hila
Ezra, Yossef
Kabiri, Doron
author_facet Luxenbourg, Danielle
Porat, Shay
Romero, Roberto
Raif Nesher, Dror
Haj Yahya, Rani
Sompolinsky, Yishai
Hochler, Hila
Ezra, Yossef
Kabiri, Doron
author_sort Luxenbourg, Danielle
collection PubMed
description OBJECTIVE: To 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. METHODS: A 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. RESULTS: The 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. CONCLUSION: Progesterone 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.
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spelling pubmed-100177342023-03-17 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 Luxenbourg, Danielle Porat, Shay Romero, Roberto Raif Nesher, Dror Haj Yahya, Rani Sompolinsky, Yishai Hochler, Hila Ezra, Yossef Kabiri, Doron Front Med (Lausanne) Medicine OBJECTIVE: To 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. METHODS: A 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. RESULTS: The 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. CONCLUSION: Progesterone 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. Frontiers Media S.A. 2023-03-02 /pmc/articles/PMC10017734/ /pubmed/36936220 http://dx.doi.org/10.3389/fmed.2023.1130942 Text en Copyright © 2023 Luxenbourg, Porat, Romero, Raif Nesher, Haj Yahya, Sompolinsky, Hochler, Ezra and Kabiri. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Luxenbourg, Danielle
Porat, Shay
Romero, Roberto
Raif Nesher, Dror
Haj Yahya, Rani
Sompolinsky, Yishai
Hochler, Hila
Ezra, Yossef
Kabiri, Doron
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 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 Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017734/
https://www.ncbi.nlm.nih.gov/pubmed/36936220
http://dx.doi.org/10.3389/fmed.2023.1130942
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