Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis.
Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis.
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DOI：
10.1111/1471-0528.13032
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Global Obstetrics Network (GONet) collaboration
中科院分区：
文献类型：
--
作者：
Schuit E;Stock S;Rode L;Rouse DJ;Lim AC;Norman JE;Nassar AH;Serra V;Combs CA;Vayssiere C;Aboulghar MM;Wood S;Çetingöz E;Briery CM;Fonseca EB;Worda K;Tabor A;Thom EA;Caritis SN;Awwad J;Usta IM;Perales A;Meseguer J;Maurel K;Garite T;Aboulghar MA;Amin YM;Ross S;Cam C;Karateke A;Morrison JC;Magann EF;Nicolaides KH;Zuithoff NP;Groenwold RH;Moons KG;Kwee A;Mol BW;Global Obstetrics Network (GONet) collaboration
In twin pregnancies, the rates of adverse perinatal outcome and subsequent long-term morbidity are substantial, and mainly result from preterm birth (PTB). 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). We searched international scientific databases, trial registration websites, and references of identified articles. Randomised clinical trials (RCTs) of 17-hydroxyprogesterone caproate (17Pc) or vaginally administered natural progesterone, compared with placebo or no treatment. 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. 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). 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.
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DOI：
10.1111/1471-0528.13031
发表时间：
2015-01-01
影响因子：
5.8
作者：
Awwad, J.;Usta, I. M.;Nassar, A. H.
通讯作者：
Nassar, A. H.
影响因子：
7.1
作者：
Hassan, S. S.;Romero, R.;Creasy, G. W.
通讯作者：
Creasy, G. W.
影响因子：
4
作者：
Aboulghar, Mona M.;Aboulghar, Mohamed A.;Serour, Gamal I.
通讯作者：
Serour, Gamal I.
影响因子：
9.8
作者：
Romero R;Nicolaides K;Conde-Agudelo A;Tabor A;O'Brien JM;Cetingoz E;Da Fonseca E;Creasy GW;Klein K;Rode L;Soma-Pillay P;Fusey S;Cam C;Alfirevic Z;Hassan SS
通讯作者：
Hassan SS
影响因子：
2.6
作者：
Cetingoz, Elcin;Cam, Cetin;Sancak, Ali
通讯作者：
Sancak, Ali