BACKGROUND: The consequences of preterm birth not only for the baby but also for the mother has been well documented over the years. Numerous interventions have been tried and tested and yet it is still a significant problem to date. Progesterone has been documented to be an effective prophylactic drug against preterm labor for those considered at high risk for developing the condition. However, little is known its effectiveness when given in oral form as a maintenance tocolysis for those who already suffered from an acute episode or preterm labor.
OBJECTIVE:To evaluate the effectiveness of oral progesterone in the prevention of preterm birth after being diagnosed of preterm labor
DESIGN: Meta-analysis
SUBJECTS: The study population consisted of women with singleton gestation who were diagnosed with preterm labor, defined as having contractions associated with corresponding cervical dilatation, which were treated with oral progesterone as a maintenance tocolytic until delivery.
DATA COLLECTION: Journals were searched in different journal databases. Reviewers independently assessed the eligibility of the articles included in this study. Methodologic quality was reviewed using the Cochrane handbook for systematic reviews of interventions. Version 5.1.0 (updated March 2011). Data extracted were analysed using the Review Manager 5.3 Software (Revman 2014) and the Comprehensive Meta-Analysis Software (CMA3 2016).
RESULTS: No statistical difference was noted in terms of latency prolongation, gestational age at birth, occurrence of preterm birth, and on neonatal outcomes such as APGAR Score < 7 at birth, neonatal death between those who received progesterone and those who did not. However, babies in the progesterone group had a mean birthweight higher than their placebo counterparts.
CONCLUSION: The use of oral progesterone as a maintenance tocolysis after arrested preterm labor showed no statistically significant benefit except for higher birthweight in babies upon delivery.