Evidence map›Paper›PMID 17671254›Full record

Trial reportThe New England journal of medicine2007

Progesterone and the risk of preterm birth among women with a short cervix.

Eduardo B Fonseca, Ebru Celik, Mauro Parra, Mandeep Singh, Kypros H Nicolaides, Fetal Medicine Foundation Second Trimester Screening Group

7 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 269 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
269citing papers in PubMed, 21 pooled it
31.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00422526 phase3completednot on this map

Randomised Study to Examine the Effectiveness of Progesterone in Preventing Severe Preterm Delivery

TypeinterventionalSponsorKing's College Hospital NHS TrustRan2003 to 2006Enrolled250ConditionsPreterm Birth, Pregnancy Trimester, SecondArmsMicronised progesterone (Utrogestan)
NCT00615550 phase3completednot on this mapstarted 2008, after this paper: background citation

The Effect of Vaginal Progesterone Administration in the Prevention of Preterm Birth in Women With a Short Cervix [Vaginal Progesterone Bioadhesive Gel (Prochieve)® Extending Gestation A New Therapy for Short Cervix - Trial (PREGNANT Short Cervix - Trial)]

TypeinterventionalSponsorJuniper Pharmaceuticals, Inc.Ran2008 to 2010Enrolled465ConditionsPreterm Delivery, Short Cervix, Short Uterine Cervical LengthArmsprogesterone, placebo
NCT01482039 naunknown statusnot on this mapstarted 2011, after this paper: background citation

Patient Attitudes Regarding Abdominal Versus Transvaginal Ultrasonography for Assessment of the Cervical Length in Low Risk Patients: a Randomized Trial

TypeinterventionalSponsorIntermountain Women and Children's ResearchRan2011 to 2012Enrolled210ConditionsCervical InsufficiencyArmsSequential ultrasound, Transvaginal ultrasound
NCT01840228 naterminatednot on this mapstarted 2013, after this paper: background citation

Vaginal Progesterone for the Prevention of Preterm Birth in Women With Arrested Preterm Labor

TypeinterventionalSponsorWashington University School of MedicineRan2013 to 2018Enrolled38ConditionsPremature Birth, Obstetric Labor, PrematureArmsMicronized progesterone suppository
NCT01959464 phase4completednot on this mapstarted 2008, after this paper: background citation

Sexual Absorption of Vaginal Progesterone

TypeinterventionalSponsorWake Forest University Health SciencesRan2008 to 2010Enrolled20ConditionsInfertility, PregnancyArmsCrinone vaginal progesterone gel, Placebo vaginal gel
NCT02901626 phase3terminatednot on this mapstarted 2017, after this paper: background citation

A Randomized Trial of Pessary in Singleton Pregnancies With a Short Cervix

TypeinterventionalSponsorThe George Washington University Biostatistics CenterRan2017 to 2022Enrolled544ConditionsShort Cervix, Preterm DeliveryArmsArabin Cervical Pessary
NCT06385366 enrolling by invitationnot on this mapstarted 2024, after this paper: background citation

Developing and Evaluating Models for Early Prediction of Obstetrical Diseases: Preeclampsia, Spontaneous Preterm Birth, and Gestational Diabetes in The Pregnant Women Performed Non-invasive Prenatal Screening (NIPT)

TypeobservationalSponsorGene SolutionsRan2024 to 2025Enrolled1,105ConditionsPregnant With Complication, Preeclampsia, Preterm Birth, Gestational Diabetes
3 · Its place in the literature

Who cites it

269 citing papers in PubMed, 21 syntheses or guidelines pooled it, 1,075 citations in OpenAlex.

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  6. Vaginal progesterone for the prevention of preterm birth and adverse perinatal outcomes in twin gestations with a short cervix: an updated individual patient data meta-analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2022
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  15. Vaginal progesterone decreases preterm birth and neonatal morbidity and mortality in women with a twin gestation and a short cervix: an updated meta-analysis of individual patient data.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2017
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  17. Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2016
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  18. 17-Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta-analysis.BJOG : an international journal of obstetrics and gynaecology · 2016
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209 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Eduardo B FonsecaHarris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, United Kingdom.
Ebru Celik
Mauro Parra
Mandeep Singh
Kypros H Nicolaides
Fetal Medicine Foundation Second Trimester Screening Group
King's College Hospital · GBHarris Birthright Research Centre for Fetal Medicine · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious randomized trials have shown that progesterone administration in women who previously delivered prematurely reduces the risk of recurrent premature delivery. Asymptomatic women found at midgestation to have a short cervix are at greatly increased risk for spontaneous early preterm delivery, and it is unknown whether progesterone reduces this risk in such women.

methodsCervical length was measured by transvaginal ultrasonography at a median of 22 weeks of gestation (range, 20 to 25) in 24,620 pregnant women seen for routine prenatal care. Cervical length was 15 mm or less in 413 of the women (1.7%), and 250 (60.5%) of these 413 women were randomly assigned to receive vaginal progesterone (200 mg each night) or placebo from 24 to 34 weeks of gestation. The primary outcome was spontaneous delivery before 34 weeks.

resultsSpontaneous delivery before 34 weeks of gestation was less frequent in the progesterone group than in the placebo group (19.2% vs. 34.4%; relative risk, 0.56; 95% confidence interval [CI], 0.36 to 0.86). Progesterone was associated with a nonsignificant reduction in neonatal morbidity (8.1% vs. 13.8%; relative risk, 0.59; 95% CI, 0.26 to 1.25; P=0.17). There were no serious adverse events associated with the use of progesterone.

conclusionsIn women with a short cervix, treatment with progesterone reduces the rate of spontaneous early preterm delivery. (ClinicalTrials.gov number, NCT00422526 [ClinicalTrials.gov].).

Indexed as

Administration, IntravaginalAdultCervix UteriFemaleHumansKaplan-Meier EstimateLogistic ModelsPregnancyPregnancy, MultiplePregnancy OutcomePremature BirthProgesteroneRiskProgesterone

Identifiers

PMID17671254
OpenAlexW2003105309

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

and 1 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.