![]() ![]() The prevalence of premature births varies from 5% to 18%, with approximately 15 million babies being born preterm every year. Prematurity is the leading cause of death in children under 5 years of age. Systematic Review Registration: PROSPERO, identifier CRD42020165198. ![]() No differences were found between vaginal micronized progesterone in gel or capsule formulations. In the network meta-analysis, no significant difference was demonstrated (OR = 0.85 95% CI, 0.43–1.69) between the effect of the two formulations of vaginal micronized progesterone (vaginal gel versus vaginal capsules) on the risk of PTB.Ĭonclusion: Vaginal progesterone is associated with a decreased risk of premature birth in women with a shortened cervix in the second trimester of pregnancy. The meta-analysis demonstrated that vaginal micronized progesterone significantly reduces preterm birth risk, Risk Ratio = 0.63 95% CI, 0.48–0.82 p = 0.0006 with no heterogeneity between the studies: I 2 = 0%. Results: Five studies met the inclusion criteria (4 RCTs, one cohort study) including 1,048 women. This analysis was performed using the network meta-analysis package within the R environment. We then performed a network meta-analysis to pool indirect comparisons between the two formulations (gel vs capsule). We pooled results of the primary outcome for individual studies using a random-effect model. ![]() Heterogeneity of treatment effect was assessed with the I 2 statistic. Pooled relative risks (RR) and 95% CI’s were calculated for dichotomous outcomes. The primary outcome was preterm birth ≤33 weeks of gestation. Study appraisal and synthesis methods: Assessments of the risk of bias of RCTs were performed by applying the Cochrane Collaboration’s Risk of Bias Tool non-randomized control trials were evaluated with the Newcastle–Ottawa Scale (NOS). We searched for progesterone administration to prevent preterm birth in asymptomatic women with a shortened cervix (<25 mm) measured by ultrasound in the second trimester of singleton pregnancy. Study eligibility criteria: Randomized controlled trials (RCTs), prospective and retrospective observational studies were included. Objective: To evaluate the effectiveness of vaginal progesterone in preventing preterm birth in women with a singleton gestation and short cervical length and to determine which of the two formulations, micronized progesterone vaginal capsule versus vaginal gel containing micronized progesterone, is more effective for preventing preterm birth.ĭata sources: A systematic search was performed in the following databases: EMBASE, PubMed (MEDLINE), The Cochrane Library, and the Clinical Trials Registry ( ).
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