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We conducted a systematic review and meta\u2010analysis to assess the effectiveness and safety of progestogens for these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We searched Medline, Embase, and Cochrane Central Registry of Controlled Trials up to October 6, 2023 for randomized control trials (RCTs) comparing progestogen supplementation to placebo or no treatment for pregnant women with threatened or recurrent miscarriage. We assessed the risk of bias using a modified version of the Cochrane risk\u2010of\u2010bias tool and the certainty of evidence using the GRADE approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 15 RCTs (6616 pregnancies) reporting on threatened or recurrent miscarriage, 12 (5610 pregnancies) reported on threatened miscarriage with or without a prior history of miscarriage. Results indicated that progesterone probably increases live births (relative risk (RR) 1.04, 95% confidence interval (CI) 0.99\u20131.10, absolute increase 3.1%, moderate certainty). Of these RCTs, three (1973 pregnancies) reporting on threatened miscarriage with a prior history of miscarriage indicated that progesterone possibly increases live births (RR 1.06, 95% CI: 0.97\u20131.16, absolute increase 4.4%; low certainty), while four (2540 pregnancies) reporting on threatened miscarriage and no prior miscarriage left the effect very uncertain (RR 1.02, 95% CI: 0.96\u20131.10, absolute increase 1.7%; very low certainty). Three trials reporting on 1006 patients with a history of two or more prior miscarriages indicated progesterone probably increases live births (RR 1.08, 95% CI: 0.98\u20131.19, absolute increase 5.7%, moderate certainty). Six RCTs that reported on 2979 patients with at least one prior miscarriage indicated that progesterone probably increases live births (RR 1.07, 95% CI: 1.01\u20131.13, absolute increase 5.0%; moderate certainty). Progesterone probably has little or no effect on congenital anomalies (RR 1.06, 95% CI: 0.76\u20131.48, absolute increase 0.1%; moderate certainty), and other serious adverse pregnancy events (RR 1.07, 95% CI: 0.83\u20131.40, absolute increase 0.2%, moderate certainty).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women at increased risk of pregnancy loss, progestogens probably increase live births without increasing adverse maternal and neonatal events. It remains possible that the benefit is restricted to those with prior miscarriages.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14829","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T05:42:07Z","timestamp":1710394927000},"page":"1689-1701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Progestogens in women with threatened miscarriage or recurrent miscarriage: A meta\u2010analysis"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2621-8740","authenticated-orcid":false,"given":"Yunli","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine The Second Affiliated Hospital of Chongqing Medical University  Chongqing China"},{"name":"Chongqing Municipality Clinical Research Center for Geriatrics The Second Affiliated Hospital of Chongqing Medical University  Chongqing China"},{"name":"The Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University  Hamilton Ontario Canada"},{"name":"Department of Obstetrics and Gynecology McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University  Hamilton Ontario Canada"},{"name":"Evidence\u2010Based Medicine Center, School of Basic Medical Sciences Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiukui","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University  Hamilton Ontario Canada"},{"name":"School of Rehabilitation Science McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Kallas\u2010Silva","sequence":"additional","affiliation":[{"name":"Faculdade Israelita de Ci\u0207ncias da Sa\u00fade Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy P.","family":"Steen","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Guyatt","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.06.048"},{"key":"e_1_2_11_3_1","first-page":"759","article-title":"Endometrial progesterone and estradiol receptors in patients with recurrent early pregnancy loss of unknown etiology\u2014preliminary report","volume":"6","author":"Carranza\u2010Lira S","year":"2000","journal-title":"Med Sci Monit"},{"key":"e_1_2_11_4_1","unstructured":"WHO.Why we need to talk about losing a baby. 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