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Progestogens for Prevention of Preterm Birth
Authors: Kjersti Aagaard, MD, PhD
Gaps in Knowledge
The effectiveness review revealed areas where the evidence is inadequate to support decisionmaking that balances the benefits and adverse effects of progestogens used to prevent spontaneous preterm birth.
- The thresholds where improved gestational age and birth weight translate into improved neonatal and childhood outcomes are not known.
- The differences in effectiveness between different formulations and dosages, timing of initiation, and duration of treatment have not been studied in head-to-head comparisons.
- The influence of potential modifiers (e.g., body mass index, short cervix) has not been determined.
- The effects on maternal outcomes (e.g., hospitalization, tocolysis, gestational diabetes, hypertension) are not known.
- Patient adherence to treatment and reasons for discontinuation are rarely reported or investigated.
- Long-term risks are not known, and no surveillance database is available for reporting adverse events.
Keywords: preterm birth | progesterone | progestogens | progestins | adherence | maternal outcome | surveillance | gestational age | birth weight
- 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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