{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T11:56:26Z","timestamp":1783770986909,"version":"3.55.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"name":"Colorado Center for Personalized Medicine's Health Data Compass Data Warehouse project"},{"name":"National Institutes of Health Colorado Clinical and Translational Science Awards","award":["UL1 TR002535"],"award-info":[{"award-number":["UL1 TR002535"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The goal of this study is to evaluate whether adjuvant progesterone following cerclage affords a reduction in the rate of preterm delivery.<\/jats:p>\n                  <jats:p>This is a retrospective cohort review of all individuals who underwent transvaginal cerclage placement at a tertiary care academic medical center between 2005 and 2021. The rate of delivery prior to 37 weeks and several secondary maternal and neonatal outcomes were compared between patients with and without progesterone supplementation after cerclage. Multivariable regression, subgroup, and matched pairs analyses were performed in order to account for the formulation of progesterone, indication for cerclage, and other potential confounding variables. The study was powered a priori to detect a difference in our primary outcome.<\/jats:p>\n                  <jats:p>Among 451 patients, there were 163 history-, 135 ultrasound-, and 153 examination-indicated cerclages. Overall, 284 (63%) received adjuvant progesterone. Adjuvant progesterone was associated with an increased rate of preterm delivery before 37 weeks (45 vs. 34%, p\u2009=\u20090.03) with an adjusted odds ratio of 1.78 (95% confidence interval: 1.14 and 2.80) in our multivariable model. The median latency from cerclage placement to delivery was shorter when progesterone was used (119 vs. 139 days, p\u2009&lt;\u20090.001). There was no benefit of adjuvant progesterone when analyzed by formulation of progesterone or indication for cerclage or when analyzing pairs matched based on propensity score matching. There were no differences in secondary outcomes for pregnant patients or their offspring.<\/jats:p>\n                  <jats:p>Adjuvant progesterone does not decrease the preterm delivery rate and may in fact cause harm by decreasing latency from cerclage to delivery. Maternal and neonatal outcomes do not vary with supplemental progesterone after cerclage. Our data do not support a synergistic benefit of cerclage and postcerclage progesterone.<\/jats:p>","DOI":"10.1055\/a-2605-7721","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T19:58:51Z","timestamp":1747079931000},"page":"291-299","source":"Crossref","is-referenced-by-count":1,"title":["Progesterone Supplementation after Cerclage Does Not Improve the Preterm Birth Rate"],"prefix":"10.1055","volume":"43","author":[{"given":"Lauren C.","family":"Sayres","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie T.","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia A.","family":"Lijewski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanelle","family":"Sheeder","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane A.","family":"Reeves","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/ijgo.13195","article-title":"Global burden of preterm birth","volume":"150","author":"S R Walani","year":"2020","journal-title":"Int J Gynaecol Obstet"},{"issue":"442","key":"ref2","first-page":"1","article-title":"Births in the United States, 2021","author":"J A Martin","year":"2022","journal-title":"NCHS Data Brief"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"e65","DOI":"10.1097\/AOG.0000000000004479","article-title":"Practice bulletin 234: prediction and prevention of spontaneous preterm birth","volume":"138","author":"American College of Obstetricians and Gynecologists","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1002\/uog.15953","article-title":"Vaginal progesterone decreases preterm birth\u2009\u2264\u200934\u2009weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study","volume":"48","author":"R Romero","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"100658","DOI":"10.1016\/j.ajogmf.2022.100658","article-title":"Vaginal progesterone compared with intramuscular 17-alpha-hydroxyprogesterone caproate for prevention of recurrent preterm birth in singleton gestations: a systematic review and meta-analysis","volume":"4","author":"R C Boelig","year":"2022","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1055\/s-0039-3400227","article-title":"17-OHPC to prevent recurrent preterm birth in singleton gestations (PROLONG study): a multicenter, international, randomized double-blind trial","volume":"37","author":"S C Blackwell","year":"2020","journal-title":"Am J Perinatol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1002\/ijgo.13148","article-title":"Effect of adjunctive vaginal progesterone after McDonald cerclage on the rate of second-trimester abortion in singleton pregnancy: a randomized controlled trial","volume":"149","author":"M K Ali","year":"2020","journal-title":"Int J Gynaecol Obstet"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1080\/14767058.2017.1280019","article-title":"Does adjunctive use of progesterone in women with cerclage improve prevention of preterm birth?","volume":"31","author":"R G Sinkey","year":"2018","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1007\/s00404-020-05482-w","article-title":"Outcomes of ultrasound and physical-exam based cerclage: assessment of risk factors and the role of adjunctive progesterone in preventing preterm birth-a retrospective cohort study","volume":"301","author":"M Lavie","year":"2020","journal-title":"Arch Gynecol Obstet"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1111\/jog.13128","article-title":"Addition of adjuvant progesterone to physical-exam-indicated cervical cerclage to prevent preterm birth","volume":"42","author":"E Y Jung","year":"2016","journal-title":"J Obstet Gynaecol Res"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1111\/aogs.13488","article-title":"Adjuvant 17-hydroxyprogesterone caproate in women with history-indicated cerclage: a systematic review and meta-analysis","volume":"98","author":"A C Eke","year":"2019","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"18","key":"ref13","doi-asserted-by":"crossref","first-page":"3177","DOI":"10.1080\/14767058.2019.1568406","article-title":"Adjuvant 17-hydroxyprogesterone caproate in women with ultrasound-indicated cerclage: a systematic review and meta-analysis","volume":"33","author":"K E Lichter","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"09","key":"ref15","first-page":"CD012871","article-title":"Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies","volume":"9","author":"G U Eleje","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/OGX.0b013e31828737c7","article-title":"Emergency cerclage: literature review","volume":"68","author":"S Namouz","year":"2013","journal-title":"Obstet Gynecol Surv"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2605-7721.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:11:49Z","timestamp":1770682309000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2605-7721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":14,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,2,9]]},"published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2605-7721","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5,12]]},"published":{"date-parts":[[2025,5,12]]}}}