Dataset Information

Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis.

ABSTRACT:

Background

In twin pregnancies, the rates of adverse perinatal outcome and subsequent long-term morbidity are substantial, and mainly result from preterm birth (PTB).

Objectives

To assess the effectiveness of progestogen treatment in the prevention of neonatal morbidity or PTB in twin pregnancies using individual participant data meta-analysis (IPDMA).

Search strategy

We searched international scientific databases, trial registration websites, and references of identified articles.

Selection criteria

Randomised clinical trials (RCTs) of 17-hydroxyprogesterone caproate (17Pc) or vaginally administered natural progesterone, compared with placebo or no treatment.

Data collection and analysis

Investigators of identified RCTs were asked to share their IPD. The primary outcome was a composite of perinatal mortality and severe neonatal morbidity. Prespecified subgroup analyses were performed for chorionicity, cervical length, and prior spontaneous PTB.

Main results

Thirteen trials included 3768 women and their 7536 babies. Neither 17Pc nor vaginal progesterone reduced the incidence of adverse perinatal outcome (17Pc relative risk, RR 1.1; 95% confidence interval, 95% CI 0.97-1.4, vaginal progesterone RR 0.97; 95% CI 0.77-1.2). In a subgroup of women with a cervical length of ?25 mm, vaginal progesterone reduced adverse perinatal outcome when cervical length was measured at randomisation (15/56 versus 22/60; RR 0.57; 95% CI 0.47-0.70) or before 24 weeks of gestation (14/52 versus 21/56; RR 0.56; 95% CI 0.42-0.75).

Author's conclusions

In unselected women with an uncomplicated twin gestation, treatment with progestogens (intramuscular 17Pc or vaginal natural progesterone) does not improve perinatal outcome. Vaginal progesterone may be effective in the reduction of adverse perinatal outcome in women with a cervical length of ?25 mm; however, further research is warranted to confirm this finding.

SUBMITTER: Schuit E

PROVIDER: S-EPMC5909188 | biostudies-literature | 2015 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis.

Schuit E E Stock S S Rode L L Rouse D J DJ Lim A C AC Norman J E JE Nassar A H AH Serra V V Combs C A CA Vayssiere C C Aboulghar M M MM Wood S S Çetingöz E E Briery C M CM Fonseca E B EB Worda K K Tabor A A Thom E A EA Caritis S N SN Awwad J J Usta I M IM Perales A A Meseguer J J Maurel K K Garite T T Aboulghar M A MA Amin Y M YM Ross S S Cam C C Karateke A A Morrison J C JC Magann E F EF Nicolaides K H KH Zuithoff N P A NP Groenwold R H H RH Moons K G M KG Kwee A A Mol B W J BW

BJOG : an international journal of obstetrics and gynaecology 20140822 1

<h4>Background</h4>In twin pregnancies, the rates of adverse perinatal outcome and subsequent long-term morbidity are substantial, and mainly result from preterm birth (PTB).<h4>Objectives</h4>To assess the effectiveness of progestogen treatment in the prevention of neonatal morbidity or PTB in twin pregnancies using individual participant data meta-analysis (IPDMA).<h4>Search strategy</h4>We searched international scientific databases, trial registration websites, and references of identified a ...[more]

PMID: 25145491

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Dataset Information

Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis.

Background

Objectives

Search strategy

Selection criteria

Data collection and analysis

Main results

Author's conclusions

Publications

Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis.

Similar Datasets

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