Vaginal Progesterone for Preventing Preterm Birth and Adverse Perinatal Outcomes in Singleton Gestations With a Short Cervix: A Meta-Analysis of Patient Data

Abstract

(Am J Obstet Gynecol. 2018;218(2):161–180) Approximately 15 million babies worldwide are born preterm every year. A short cervical length has high predictive accuracy for spontaneous preterm birth before 34 weeks’ gestation, and a lower predictive accuracy for spontaneous preterm birth before 37 weeks. A 2012 study found vaginal progesterone was associated with a reduction in risk of preterm birth between <28 weeks gestation and <35 weeks gestation, as well as a reduction in adverse neonatal outcomes, in pregnant women with a short cervix (≤25 mm). In 2016 a randomized controlled trial (RCT) published conflicting results and showed vaginal progesterone did not reduce the risk of preterm birth or perinatal morbidity. This systematic review and meta-analysis aimed to determine whether vaginal progesterone reduced the incidence of preterm birth in women with a singleton gestation and short cervix.