Skip to main content
SpringerLink
Log in

Efficacy of progesterone on threatened miscarriage: an updated meta-analysis of randomized trials

  • Review
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The efficacy of progesterone supplementation in the treatment of threatened miscarriage is controversial. This meta-analysis was to evaluate the correlation between progesterone and improving pregnancy outcomes in women with threatened miscarriage.

Methods

We searched PubMed, EMBASE, and the Cochrane Library for relevant randomized controlled trials (RCTs) to demonstrate the efficacy of progesterone on the threatened miscarriage pregnancy. The outcomes were miscarriage, preterm birth, and live birth.

Results

Nine RCTs comparing 4907 patients were included in this study. Compared with placebo or no treatment, progesterone supplementation had a relationship with a reduction in the rate of miscarriage [RR 0.70 95% Cl (0.52, 0.94)]. There was no significant difference between progesterone supplementation and placebo or no treatment in preterm birth [RR 0.87 95% Cl (0.52, 1.47) and live birth (RR 1.02 95% Cl (0.98, 1.07)].

Conclusion

Progesterone supplementation did not significantly improve the incidence of preterm and live birth, so progesterone treatment of threatened miscarriage may be unhelpful.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Cunningham FG (ed) (2001) Physiology of pregnancy. Williams Obstetrics, 21st edn. McGraw-Hill, New York

    Google Scholar 

  2. Duan L, Yan D, Zeng W, Yang X, Wei Q (2010) Effect of progesterone treatment due to threatened miscarriage in early pregnancy for obstetric and perinatal outcomes. Early Hum Dev 86(1):41–43

    Article  CAS  Google Scholar 

  3. Coomarasamy A, Devall AJ, Cheed V et al (2019) Randomized trial of progesterone in women with bleeding in early pregnancy. N Engl J Med 380:1815–1824

    Article  CAS  Google Scholar 

  4. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Loannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–e34

    Article  Google Scholar 

  5. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta analyses. BMJ 327:557–560

    Article  Google Scholar 

  6. Palagiano A, Bulletti C, Pace MC, Ziegler DE, Cicinelli E, Lzzo A (2004) Effects of vaginal progesterone on pain and uterine contractility in patients with threatened miscarriage before twelve weeks of pregnancy. Ann NY Acad Sci 1034:200–210

    Article  CAS  Google Scholar 

  7. Alimohamadi S, Javadian P, Gharedaghi MH, Javadian N, Alinia H, Khazardoust S, Borna S, Hantoushzadeh S (2013) Progesterone and threatened miscarriage: a randomized clinical trial on endocervical cytokine concentrations. J Reprod Immunol 98:52–60

    Article  CAS  Google Scholar 

  8. Gerhard I, Gwinner B, Eggert-Kruse W, Runnebaum B (1987) Double-blind controlled trial of progesterone substitution in threatened miscarriage. Biol Res Pregnancy Perinatol 8:26–34

    CAS  PubMed  Google Scholar 

  9. Yassaee F, Shekarriz-Foumani R, Afsari S, Fallahian M (2014) The effect of progesterone suppositories on threatened miscarriage: a randomized clinical trial. J Reprod Infertil 15:147–151

    PubMed  PubMed Central  Google Scholar 

  10. Pandian RU (2009) Dydrogesterone in threatened miscarriage: a Malaysian experience. Maturitas 65S:S47–S50

    Article  Google Scholar 

  11. Omar MH, Mashita MK, Lim PS, Jamil MA (2005) Dydrogesterone in threatened miscarriage: pregnancy outcome.J. Steroid Biochem Mol Biol 97:421–425

    Article  CAS  Google Scholar 

  12. Turgal M, Aydin E, Ozyuncu O (2017) Effect of micronized progesterone on fetal-placental volume in first-trimester threatened miscarriage. J Clin Ultrasound 45:14–19

    Article  Google Scholar 

  13. El-Zibdeh MY, Yousef LT (2009) Dydrogesterone support in threatened miscarriage. Maturitas 65S:S43–S46

    Article  CAS  Google Scholar 

  14. Wang XX, Luo Q, Bai WP (2019) Efficacy of progesterone on threatened miscarriage: difference in drug types. J Obstet Gynaecol Res 45:794–802

    Article  CAS  Google Scholar 

  15. Lee HJ, Park TC, Kim JH, Norwitz E, Lee B (2017) The influence of oral dydrogesterone and vaginal progesterone on threatened miscarriage: a systematic review and meta-analysis. Biomed Res Int 2017:3616875

    PubMed  PubMed Central  Google Scholar 

  16. Barbosa MW, Silva LR, Navarro PA, Ferriani RA, Nastri CO, Martins WP (2016) Dydrogesterone vs progesterone for luteal-phase support: systematic review and meta-analysis of randomized controlled trials. Ultrasound Obstet Gynecol 48:161–170

    Article  CAS  Google Scholar 

  17. Haas DM, Ramsey PS (2013) Progestogen for preventing miscarriage. Cochrane Database Syst Rev 10(2):CD003511

    Google Scholar 

  18. Wahabi HA, Fayed AA, Esmaeil SA, Bahkali KH (2018) Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev 8:CD005943

    PubMed  Google Scholar 

  19. Coomarasamy A, Devall Adam J, Brosens Jan J et al (2020) Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence [J]. Am J Obstet Gynecol 223:167–176

    Article  CAS  Google Scholar 

Download references

Funding

The work was not supported by any fund/grant.

Author information

Authors and Affiliations

  1. Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning, China

    Yuying Yan, Zeping Chen, Ying Yang & Xinkuo Zheng

  2. Department of Pharmaceutical Sciences, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning, China

    Meijuan Zou & Gang Cheng

  3. No. 230 Hospital of P.L.A., 19 Shijing Street, Dandong, 118000, Liaoning, China

    Zhenting Yuan

Authors
  1. Yuying Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zeping Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ying Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xinkuo Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meijuan Zou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gang Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zhenting Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Yuying Yan contributed to project development and study selection and manuscript writing; ZPC contributed to study selection and disagreement judgment; YY, XKZ contributed to data extraction; MJZ contributed to manuscript revision; GC, ZTY contributed to manuscript revision and final approval.

Corresponding authors

Correspondence to Gang Cheng or Zhenting Yuan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

This study was based on review of published studies, and it was not necessary to obtain informed consent from individual participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yan, Y., Chen, Z., Yang, Y. et al. Efficacy of progesterone on threatened miscarriage: an updated meta-analysis of randomized trials. Arch Gynecol Obstet 303, 27–36 (2021). https://doi.org/10.1007/s00404-020-05808-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05808-8

Keywords

Search

Navigation