The use of progesterone and other progestational agents to prevent spontaneous preterm labour and preterm birth

Abstract

Background: Preterm birth is the major cause of perinatal mortality and morbidity in the developed world, making a huge impact on healthcare costs. There is accumulating evidence that the prophylactic use of progestagens is able to reduce significantly the incidence of low birth weight and preterm birth. Objectives: to emphasise the importance of preterm birth; to review the role of progesterone in inducing myometrial quiescence which prevent preterm labour and preterm birth; to review the published literature and planned future research on the use of progestagens for the prevention of preterm birth. Methods: A review of the published literature using accepted search engines. Results/conclusions: Progestagens have been demonstrated to reduce the incidence of low birth weight and preterm birth. Many questions remain unanswered, particularly the long-term safety concerns and also whether the use of progestagens results in improved neonatal and childhood outcomes.

Keywords::

• birth
• labour
• prematurity
• preterm
• prevention
• progestagens
• progestational agents
• progesterone
• prophylactic
• prophylaxis
• tocolysis
• tocolytics

Acknowledgments

The authors would like to thank Pauline Mills from Northwick Park Hospital for her secretarial help.