Progestogens for Prevention of Preterm Birth
Studies and Results by Indication (1 of 3)
Several studies investigated the effects of progestogens in women categorized by a specific risk factor (the indication).
In 4 studies of women with a risk of preterm birth due to having a prior spontaneous preterm birth, a total of 1,318 women were studied in treated and control groups. The odds ratio for the pooled studies was 0.66, with a 95 percent confidence interval ranging from 0.53 to 0.82. The absolute risk reduction is 9.4 percent, and the number needed to treat is 11. The strength of evidence is moderate for this finding.
In 3 studies, birth weights were determined for infants of 859 treated and untreated women. No statistically significant difference in birth weights was found, and the mean difference was calculated to be 239 g, with a 95-percent confidence interval ranging from 44.5 grams less in the progestogen group to 523.3 g more in the progestogen group. The strength of evidence for this finding is moderate.
Fetal/neonatal death rates were determined in 3 studies of 1,318 women. The risk of fetal/neonatal death was reduced by nearly half, with a 95-percent confidence interval ranging from as much as a 75-percent reduction in risk to as little as a 4-percent reduction in risk. The absolute risk reduction is 1.7 percent, and the number needed to treat is 58. The strength of evidence for this finding is low.
Two studies were reviewed that treated women with a short cervix with progestogens. In the first study of 250 women, the absolute risk reduction for risk of birth at less than 34 weeks was 8.8 percent. In the second study of 458 women, the absolute risk reduction for risk of birth at less than 33 weeks was 15.25 percent.
Keywords: birth weight | fetal mortality | multiple gestations | neonatal mortality | progesterone | progestins | progestogens | spontaneous preterm birth | triplets | twins | Preterm birth
- Likis FE, Andrews JC, Woodworth AL, et al. Effectiveness of Progestogens for Prevention of Preterm Birth. Comparative Effectiveness Review No. 74 (Prepared by the Vanderbilt Evidence-based Practice Center under Contract No. 290-2007-10065-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2012. AHRQ Publication No. 12-EHC105-EF. Available at www.effectivehealthcare.ahrq.gov/pretermbirth.cfm.
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