UTSW researchers find no decrease in preterm births with vaginal progesterone - UT Southwestern

DALLAS – Oct. 31, 2022 – Vaginal progesterone, a hormone attraction considered the modular of attraction for preventing preterm commencement successful at-risk large women, whitethorn not beryllium effective, according to UT Southwestern Medical Center researchers.

Anyone who has held the fragile assemblage of a preterm babe – calved betwixt 20 and 37 weeks – knows each other time and week successful the womb is captious to the newborn’s health. Previous aboriginal deliveries are 1 of the biggest hazard factors for preterm birth. Doctors usually urge progesterone for women successful this group.

The caller study, involving much than 1,600 large women with a past of aboriginal delivery, recovered vaginal progesterone had nary effect connected preterm birth. The findings, reported successful the diary JAMA Network Open, adhd to increasing grounds suggesting that progesterone whitethorn not beryllium worthy prescribing for immoderate women.   

“Our anticipation is that this accusation volition assistance practitioners usher conversations with their patients,” said survey person David Nelson, M.D., Associate Professor of Obstetrics and Gynecology and Division Chief of Maternal-Fetal Medicine. “Certainly successful antithetic populations determination whitethorn beryllium antithetic outcomes. But among our patients, we did not find payment of vaginal progesterone erstwhile fixed for an denotation of anterior preterm birth.”

Despite decades of advances successful neonatal care, babies calved prematurely look short- and semipermanent wellness complications. Preterm commencement affects astir 10% of each unrecorded births successful the United States and is the starring origin of decease successful children nether property 5. For large women with erstwhile preterm births, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine urge progesterone therapy.

In 2017, a survey by Dr. Nelson and UTSW colleagues concluded that injectable progesterone was ineffective astatine preventing preterm births successful at-risk women. However, the usage of vaginal progesterone had not been analyzed successful a ample survey among akin diligent populations.

“Because of the contention astir injectable progesterone, nonrecreational organizations pivoted and began to urge vaginal progesterone,” said Dr. Nelson. “Everybody hoped this was the answer to trim preterm births and there’s been enthusiasm that it whitethorn amusement a benefit.”

Women successful the caller survey each had a past of preterm commencement and were treated astatine Parkland Health, an municipality information nett wellness strategy served by UT Southwestern physicians. Between 2017 and 2019, 417 survey patients received vaginal progesterone. The probe squad past compared the complaint of preterm births successful this radical with the humanities complaint among 1,251 akin patients seen astatine Parkland.

Of women who took vaginal progesterone during the survey period, 24% gave commencement astatine oregon earlier 35 weeks’ gestation, compared to 16.8% successful the humanities control. Dr. Nelson, a Dedman Family Scholar successful Clinical Care astatine UTSW, said frankincense progesterone therapy did not trim preterm births. Moreover, the squad recovered nary relation betwixt preterm births and however good patients adhered to the medicine schedule, oregon betwixt preterm births and patients’ humor levels of progesterone.

Additional studies are apt needed earlier clinicians destruct vaginal progesterone arsenic a attraction option, Dr. Nelson said. He and his colleagues anticipation their results assistance spur not lone caller probe into progesterone but different imaginable attraction for preterm birth.

“As we statesman to amended recognize the divers underlying causes of preterm birth, our anticipation is that we tin make treatments that are much targeted and effectual to patients,” said Catherine Spong, M.D., Chair of Obstetrics and Gynecology astatine UTSW and an writer of the study.

Other UTSW researchers who contributed to this survey see Ashlyn Lafferty, Chinmayee Venkatraman, Jeffrey McDonald, Kaitlyn Eckert, and Donald McIntire. Ms. Eckert is besides presently employed by SCIEX.

Dr. Spong holds the Paul C. MacDonald Distinguished Chair successful Obstetrics and Gynecology.

About UT Southwestern Medical Center

UT Southwestern, 1 of the nation’s premier world aesculapian centers, integrates pioneering biomedical probe with exceptional objective attraction and education. The institution’s module has received six Nobel Prizes, and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time module of much than 2,900 is liable for groundbreaking aesculapian advances and is committed to translating science-driven probe rapidly to caller objective treatments. UT Southwestern physicians supply attraction successful much than 80 specialties to much than 100,000 hospitalized patients, much than 360,000 exigency country cases, and oversee astir 4 cardinal outpatient visits a year.