Table 6. Studies examining the long-term effects of prophylactic progesterone exposure in utero on childhood outcomes.
Author, year | Study population | Progesterone | Gestational age given | Delivery <34 weeks | Follow-up rate | Follow-up age | Congenital anomalies | Assessment tool 1 Progesterone vs. placebo | Assessment tool 2 Progesterone vs. placebo |
---|---|---|---|---|---|---|---|---|---|
Northen et al 2007 USA | Singletons (prior PTB) | Intramuscular 17 α-OHPC 250 mg/week | 16–20 weeks to 36 weeks | RR 0.67 (0.48–0.93) # | 80% | Mean 48 months | Genital / reproductive (2.1% vs. 1.2%; p = 1.0) | ASQ score below cut-off on at least one area (27.5% vs. 28%; p = 0.92) | PAI mean score (Boys: 66.5 vs. 67.3; p = 0.3. Girls: 32 vs. 33; p = 0.5) |
Rode et al 2011 Austria/Denmark (PREDICT) | Twins | Vaginal natural progesterone 200 mg/day | 20–24 weeks to 34 weeks | OR 0.80 (0.5–1.2) | 79.2% and 74.8%* | 6 months, 18 months | Congenital / chromosomal (3.8% vs. 4.0%; OR 1.0, 0.5–1.7) | ASQ mean score at 6 months of age (215 vs. 218; p = 0.45) | ASQ mean score at 18 months of age (193 vs. 194; p = 0.89) |
McNamara et al 2015 United Kingdom (STOPPIT) | Twins | Vaginal natural progesterone 90 mg/day | 24 to 34 weeks | OR 1.36 (0.89–2.09) | 97% and 44%** | Mean 55 months | Congenital (4.0% vs. 4.0%; p = 0.92) | CDI score below cut-off on at least one area (30% vs. 35%; p = 0.66) | HUI global health rating‘Excellent’ (88% vs. 90%; p = 0.51) |
PTB = preterm birth. 17 α -OHPC = 17 α -hydroxyprogesterone caproate. RR = relative risk (95% confidence interval). OR = odds ratio (95% confidence interval).
ASQ = Ages and Stages Questionnaire. PAI = Preschool Activities Inventory. CDI = Child Development Inventory. HUI = Health Utilities Index.
#Delivery <35 weeks’ gestation.
*In the PREDICT study, follow-up was achieved for 79.2% of twins at 6 months of age and 74.8% of twins at 18 months of age.
**In our study, follow-up was achieved for 97% of twins via record linkage of at least one health record and 44% of twins via parental questionnaire.