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

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.