Progestogens effective for preventing preterm births in single pregnancies
There is moderate evidence that progestogen treatments, such as 17 alpha-hydroxyprogesterone caproate (17-OHP), prevent preterm birth when used by women who are having only one child and who have a history of spontaneous preterm birth (PTB), concludes a new report by the Agency for Healthcare Research and Quality (AHRQ). Progestogen is a hormone used for inhibiting the uterus from contracting and to maintain pregnancy. While effective for a singleton pregnancy, progestogens appear to be ineffective in preventing PTB among women carrying twins or triplets. There continues to be a lack of research to evaluate progestogens' influence on near-term outcomes like neonatal death and birth defects.
More research is also needed to determine whether progestogens achieve the ultimate desired outcome of preventing preterm birth deaths and promoting normal childhood development. Preterm birth is defined as delivery prior to 37 full weeks of pregnancy (39 weeks is normal). Early births are associated with more than 85 percent of all birth defects and deaths and are the leading cause of infant mortality and long-term disability. Death and birth defects caused by PTB represent distress for families, as well as significant costs to patients, health care systems, and payers. Average neonatal care costs are estimated to be $17,300 greater for preterm infants relative to term infants, amounting to more than $8.6 billion of annual medical spending in the United States.
These findings can be found in the research review, Progestogens for Prevention of Preterm Birth.
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