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Vaginal progesterone does not lessen preterm birth for high-risk women

Question clinique

In pregnant women with a history of preterm birth, does vaginal progesterone treatment decrease preterm birth or the risk and severity of respiratory distress syndrome in their infants?

L’Essentiel

Vaginal progesterone does not prevent preterm birth in high-risk women or the likelihood or severity of respiratory distress in infants. 1b

Référence

Crowther CA, Ashwood P, McPhee AJ, et al, for the PROGRESS Study Group. 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. PLoS Med 14(9): e1002390.

Plan de l'etude: Randomized controlled trial (double-blinded)

Financement: Government

Cadre: Outpatient (specialty)

Sommaire

This study was conducted in 787 pregnant women with a history of preterm birth at less than 37 weeks' recruited from 39 Australian, New Zealand, and Canadian hospitals. The women were randomized, using concealed allocation, to receive daily treatment with vaginal progesterone 100 mg daily or placebo starting at 20 weeks' gestation. Cervical length was not considered in this study. Using intention-to-treat analysis, the proportion of infants born before 37 weeks was similar in both groups: 38.2% versus 38.7%. More important, the incidence of neonatal respiratory distress as defined by the need for oxygen or respiratory support in the first 6 hours of life, was similar in both treatment groups: 10.2% versus 10.6% (P = NS). The severity of neonatal respiratory disease, if present, was similar among the 2 groups. Nearly 9% of women did not start treatment or forgot to use it 3 or more times per week.

Reviewer

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA


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Commentaires

Anonymous

good poem

avril 13, 2018
Anonymous

I commend both the authors and the publishers for bringing forward this study and its outcome. It is uncommon, in my experience, to see such s study in print

avril 13, 2018
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