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Obstet Gynecol Sci > Volume 55(10); 2012 > Article
Korean Journal of Obstetrics & Gynecology 2012;55(10):699-706.
DOI: https://doi.org/10.5468/KJOG.2012.55.10.699    Published online October 10, 2012.
Vaginal micronized natural progesterone treatment and reduced risk of recurrent preterm birth.
Lindsay Ji Hyun Seong, Min Ji Kim, Yeri Lee, So Yeon Yoon, Hyun Hwa Cha, Hye Min Kwak, Suk Joo Choi, Soo Young Oh, Cheong Rae Roh, Jong Hwa Kim
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drmaxmix.choi@samsung.com
Abstract
OBJECTIVE
To evaluate whether the administration of vaginal natural micronized progesterone is associated with reduction of recurrent preterm birth (PTB) in women with prior history of spontaneous PTB. METHODS: We retrospectively evaluated the obstetric and neonatal outcomes of all women with history of spontaneous PTB that delivered from January 2008 through April 2012. Spontaneous PTB was defined as PTB before 37 weeks of gestation due to spontaneous preterm labor or preterm premature rupture of membranes. Pregnancies with multiple gestation and those who received cerclage operation during previous or current pregnancy were excluded. Patients in the progesterone group were instructed to self-administer 100 or 200 mg vaginal micronized natural progesterone capsule. We evaluated the difference in recurrent PTB rate between the progesterone group (n = 73) and the non-user group (n = 158). RESULTS: The incidence of recurrent spontaneous PTB before 37 weeks' gestation was significantly lower in the progesterone group than the non-user group (21.9% vs. 43.0%, P=0.002). Multivariate analysis showed that progesterone therapy was associated with a decrease in the incidence of recurrent PTB before 37 weeks' gestation (odds ratio, 0.382; 95% confidence interval, 0.169-0.863; P=0.021) independent of confounding variables. CONCLUSION: Micronized vaginal progesterone supplement therapy was associated with a reduction of recurrent PTB risk in women with previous spontaneous PTB history.
Key Words: Progesterone, Preterm birth, Recurrence, Prevention


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