The Rebirth of Progesterone in the Prevention of Preterm Labor

OBJECTIVETo evaluate data since 2003 on the efficacy and safety of progesterone supplementation in the prevention of preterm labor.DATA SOURCESA MEDLINE and Ovid database search (January 2003–September 2012) was performed using the search terms preterm, progesterone, and 17α-hydroxyprogesterone caproate. All relevant abstracts were reviewed.STUDY SELECTIONFor efficacy and safety data, the search was limited to randomized, double-blind, placebo-controlled trials with the primary outcome of preterm delivery, fetal loss, or neonatal morbidity or mortality. Quality of the studies was assessed using the CONSORT (Consolidated Standards of Reporting Trials) guidelines for reporting parallel-group randomized trials. Eleven articles were selected for review.DATA SYNTHESISPreterm birth, prior to 37 weeks' gestation, remains the leading cause of neonatal morbidity and mortality in the US due to lack of treatment options. Recently, the use of progesterone to prevent preterm labor, deemed decades ago to be ineffective...