Progestogens Not Effective in Multiple Gestations

Treatment prevents preterm birth in singleton pregnancies but not in multiple gestations

TUESDAY, Sept. 18 (HealthDay News) -- Progestogen treatment may be beneficial for pregnant women who have previously given birth to preterm babies, but does not seem to be effective for multiple gestations, according to research published online Sept. 5 in Obstetrics & Gynecology.

Frances E. Likis, Dr.P.H., N.P., of the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues conducted a systematic review and meta-analysis of 34 randomized, controlled trials to evaluate the effectiveness of using progestogens to prevent preterm birth. Nineteen of these trials included data that could be included in a Bayesian meta-analysis.

The researchers found that, in women with prior preterm birth and a singleton pregnancy, progestogen treatment reduced the risk of preterm birth by 22 percent and neonatal death by 42 percent. However, in multiple gestations, the evidence did not show that progestogen treatment prevented prematurity or neonatal death. In women with preterm labor and short cervix, there was limited evidence to suggest that progestogen treatment can prevent prematurity. The evidence for other maternal, fetal, or neonatal health outcomes was inconsistent, insufficient, or absent across indications.

"Progestogens prevent preterm birth when used in singleton pregnancies for women with a prior preterm birth. In contrast, evidence suggests lack of effectiveness for multiple gestations," the authors write. "Overall, clinicians and patients lack longer-term information to understand whether intervention has the ultimately desired outcome of preventing morbidity and promoting normal childhood development."

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