{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:52:26Z","timestamp":1792119146595,"version":"4.4.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the impact of progesterone treatment on maternal and neonatal outcomes in women with a history of preterm birth and short cervical length diagnosed after 24 weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study included women with a history of preterm birth and a transvaginal sonographic cervical length measurement of \u2264 25 mm, diagnosed between 24<jats:sup>+0<\/jats:sup> and 33<jats:sup>+6<\/jats:sup> weeks of gestation. Exclusion criteria included prior progesterone treatment, cervical cerclage, or pessary. The study population was divided into the progesterone treatment group and the non-treatment group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 104 women, with 46.2% (48\/104) receiving progesterone treatment and 53.8% (56\/104) not receiving treatment. The rate of spontaneous preterm birth before 37 weeks of gestation was 43% (24\/56) in the non-treatment group and 31% (15\/48) in the progesterone treatment group (<jats:italic>P<\/jats:italic> = 0.14); the rate of spontaneous preterm birth before 34 weeks was 7% (4\/56) in the non-treatment group and 0% (0\/48) in the progesterone treatment group (<jats:italic>P<\/jats:italic> = 0.05). Progesterone treatment was associated with a significant decrease in neonatal intensive care unit admissions (OR 0.20, 95% CI 0.05\u20130.74) and in the neonatal hospitalization period (mean difference in days 2.43, 95% CI 0.44\u20134.42). The risk of recurrent spontaneous preterm birth was highest (71%) among women with two or more previous preterm deliveries who did not receive progesterone treatment, and lowest (24%) among women with one previous preterm delivery who received progesterone treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Progesterone treatment was associated with a reduction in rates of spontaneous preterm birth before 34 weeks of gestation, neonatal intensive care unit admission, and neonatal length of stay in high-risk patients, even when initiated after 24 weeks of gestation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1130942","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T05:20:18Z","timestamp":1677734418000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study"],"prefix":"10.3389","volume":"10","author":[{"given":"Danielle","family":"Luxenbourg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Porat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Romero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dror","family":"Raif Nesher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rani","family":"Haj Yahya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yishai","family":"Sompolinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hila","family":"Hochler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yossef","family":"Ezra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doron","family":"Kabiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1046\/j.1365-3016.2001.00010.x","article-title":"Risk stratification and pathological mechanisms in preterm delivery","volume":"2","author":"Lockwood","year":"2001","journal-title":"Paediatr Perinat Epidemiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/S0140-6736(08)60136-1","article-title":"An overview of mortality and sequelae of preterm birth from infancy to adulthood","volume":"371","author":"Saigal","year":"2008","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1016\/S0002-9378(99)70111-0","article-title":"The preterm prediction study: effect of gestational age and cause of preterm birth on subsequent obstetric outcome. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network","volume":"181","author":"Mercer","year":"1999","journal-title":"Am J Obstet Gynecol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1016\/j.ajog.2007.01.039","article-title":"Recurrence risk for preterm delivery","volume":"196","author":"McManemy","year":"2007","journal-title":"Am J Obstet Gynecol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.ajog.2013.09.014","article-title":"The NICHD Consecutive Pregnancies Study: recurrent preterm delivery by subtype","volume":"210","author":"Laughon","year":"2014","journal-title":"Am J Obstet Gynecol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1056\/NEJMoa035140","article-title":"Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate","volume":"348","author":"Brancazio","year":"2003","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004947.pub3","article-title":"Prenatal administration of progesterone for preventing preterm birth in women considered to be at risk of preterm birth","author":"Dodd","year":"2013","journal-title":"Cochrane Database Syst Rev."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2106","DOI":"10.1016\/S0140-6736(16)00350-0","article-title":"Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicenter, randomized, double-blind trial","volume":"387","author":"Norman","year":"2016","journal-title":"Lancet."},{"key":"B9","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1002\/uog.17245","article-title":"Vaginal progesterone vs intramuscular 17\u03b1-hydroxyprogesterone caproate for prevention of recurrent spontaneous preterm birth in singleton gestations: systematic review and meta-analysis of randomized controlled trials","volume":"49","author":"Saccone","year":"2017","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1111\/1471-0528.15566","article-title":"Vaginal progesterone, oral progesterone, 17-OHPC, cerclage, and pessary for preventing preterm birth in at-risk singleton pregnancies: an updated systematic review and network meta-analysis","volume":"126","author":"Jarde","year":"2019","journal-title":"BJOG."},{"key":"B11","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1002\/uog.5323","article-title":"Transvaginal sonographic measurement of cervical length to predict preterm birth in asymptomatic women at increased risk: a systematic review","volume":"31","author":"Crane","year":"2008","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.ajog.2017.11.576","article-title":"Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data","volume":"218","author":"Romero","year":"2018","journal-title":"Am J Obstet Gynecol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1002\/uog.9017","article-title":"Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial","volume":"38","author":"Hassan","year":"2011","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.ajog.2011.12.003","article-title":"Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data","volume":"206","author":"Romero","year":"2012","journal-title":"Am J Obstet Gynecol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1002\/uog.13241","article-title":"Predicting preterm birth in women with previous preterm birth and cervical length \u226525 mm","volume":"43","author":"Care","year":"2014","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1002\/uog.13407","article-title":"Cervical length in late second and third trimesters: a mixture model for predicting delivery","volume":"45","author":"Souka","year":"2015","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"CD007235","DOI":"10.1002\/14651858.CD007235.pub4","article-title":"Cervical assessment by ultrasound for preventing preterm delivery","volume":"9","author":"Berghella","year":"2019","journal-title":"Cochrane Database Syst Rev."},{"key":"B18","doi-asserted-by":"publisher","first-page":"100097","DOI":"10.1016\/j.ajogmf.2020.100097","article-title":"Cervical length screening after 24 weeks for prediction and prevention of preterm birth: not evidence based yet","volume":"2","author":"Berghella","year":"2020","journal-title":"Am J Obstet Gynecol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1056\/NEJM199602293340904","article-title":"The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network","volume":"334","author":"Blondel","year":"1996","journal-title":"N Engl J Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1159\/000349928","article-title":"European Association of Perinatal Medicine. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-\u22122013 update","volume":"103","author":"Kurjak","year":"2013","journal-title":"Neonatology."},{"key":"B21","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/S0022-3476(78)80282-0","article-title":"Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm","volume":"92","author":"Papile","year":"1978","journal-title":"J Pediatr."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00000658-197801000-00001","article-title":"Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging","volume":"187","author":"Bell","year":"1978","journal-title":"Ann Surg."},{"key":"B23","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1001\/archopht.123.7.991","article-title":"The international classification of retinopathy of prematurity revisited","volume":"123","year":"2005","journal-title":"Arch Ophthalmol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1164\/ajrccm.163.7.2011060","article-title":"Bronchopulmonary dysplasia","volume":"163","author":"Jobe","year":"2001","journal-title":"Am J Respir Crit Care Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1001\/jama.286.11.1340","article-title":"Mid-trimester endovaginal sonography in women at high risk for spontaneous preterm birth","volume":"286","author":"Owen","year":"2001","journal-title":"JAMA."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1861","DOI":"10.1056\/NEJMc1402822","article-title":"Prevention of preterm parturition","volume":"370","author":"Iams","year":"2014","journal-title":"N Engl J Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1016\/S0002-9378(98)70544-7","article-title":"The Preterm Prediction Study: recurrence risk of spontaneous preterm birth. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network","volume":"178","author":"Iams","year":"1998","journal-title":"Am J Obstet Gynecol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1130942\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T05:20:20Z","timestamp":1677734420000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1130942\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,2]]},"references-count":27,"alternative-id":["10.3389\/fmed.2023.1130942"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1130942","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,2]]},"article-number":"1130942"}}