Vaginal progesterone pessaries for pregnant women with a previous preterm birth to prevent neonatal respiratory distress syndrome (the PROGRESS Study): A multicentre, randomised, placebo-controlled trial - HHM

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Friday, 29 September 2017

Vaginal progesterone pessaries for pregnant women with a previous preterm birth to prevent neonatal respiratory distress syndrome (the PROGRESS Study): A multicentre, randomised, placebo-controlled trial

Caroline A. Crowther, Pat Ashwood , Andrew J. McPhee, Vicki Flenady ,
Thach Tran , Jodie M. Dodd, Jeffrey S. Robinson, for the PROGRESS Study Group



Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity. 

The withdrawal of progesterone, either actual or functional, is thought to be an antecedent to the onset of labour. There remains limited information on clinically relevant health outcomes as to whether vaginal progesterone may be of benefit for pregnant women with a history of a previous preterm birth, who are at high risk of a recurrence. 

Our primary aim was to assess whether the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth reduced the risk and severity of respiratory distress syndrome in their infants, with secondary aims of examining the effects on other neonatal morbidities and maternal health and assessing the adverse effects of treatment.

Our results do not support the use of vaginal progesterone pessaries in women with a history of a previous spontaneous preterm birth to reduce the risk of neonatal respiratory distress syndrome or other neonatal and maternal morbidities related to preterm birth.

 Individual participant data meta-analysis of the relevant trials may identify specific women for whom vaginal progesterone might be of benefit.

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