Evidence map›Paper›PMID 25145491›Full record

SynthesisBJOG : an international journal of obstetrics and gynaecology2015

Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis.

E Schuit, S Stock, L Rode, D J Rouse, A C Lim, J E Norman, A H Nassar, V Serra, C A Combs, C Vayssiere and 29 more

Registry-linked trialOpen access · greenAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BJOG : an international journal of obstetrics and gynaecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03058536 (Progesterone and Cervical Pessary in Twins), which is not on this map. Cited by 34 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 9 pooled it
28.3field-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.

NCT03058536 phase2 / phase3unknown statusnot on this mapstarted 2017, after this paper: background citation

Progesterone and Cervical Pessary in Twins : A Prospective and Randomized Study to Prevent Preterm Birth (PRECEPT)

TypeinterventionalSponsorMario Henrique Burlacchini de CarvalhoRan2017 to 2019Enrolled312ConditionsPreterm Birth, Twin Pregnancy With Antenatal ProblemArmsArabin Pessary, Vaginal Progesterone, Arabin Pessary and Progesterone
3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 9 syntheses or guidelines pooled it, 211 citations in OpenAlex.

  1. Pooled it
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  7. 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
    Pooled it
  8. 17-Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta-analysis.BJOG : an international journal of obstetrics and gynaecology · 2016
    Pooled it
  9. Pooled it
  10. Trial
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  14. Article
  15. Highlights from the International Twins Congress 2021.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2022
    Article
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  19. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

39 authors at 20 institutions in 14 countries.

E SchuitJulius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Obstetrics and Gynaecology, Academic Medical Centre Amsterdam, Amsterdam, the Netherlands.
S Stock
L Rode
D J Rouse
A C Lim
J E Norman
A H Nassar
V Serra
C A Combs
C Vayssiere
M M Aboulghar
S Wood
E Çetingöz
C M Briery
E B Fonseca
K Worda
A Tabor
E A Thom
S N Caritis
J Awwad
I M Usta
A Perales
J Meseguer
K Maurel
T Garite
M A Aboulghar
Y M Amin
S Ross
C Cam
A Karateke
J C Morrison
E F Magann
K H Nicolaides
N P A Zuithoff
R H H Groenwold
K G M Moons
A Kwee
B W J Mol
Global Obstetrics Network (GONet) collaboration
University Medical Center Utrecht · NLAmerican University of Beirut Medical Center · LBThe Egyptian IVF-ET Center · EGZeynep Kamil Hospital · TRUniversity of Calgary · CAAmsterdam UMC Location University of Amsterdam · NLBrown University · USCitrix (Switzerland) · CHCopenhagen University Hospital · DKGeorge Washington University · USHospital do Servidor Público Estadual · BRHospital Universitari i Politècnic La Fe · ESHospital Universitario Virgen de la Arrixaca · ESKing's College Hospital · GBMedical University of Vienna · ATMRC Centre for Reproductive Health · GBOrange Coast Memorial Medical Center · USRigshospitalet · DKThe University of Adelaide · AUUCHealth Yampa Valley Medical Center · US

Funding

MATERNAL FETAL RESEARCH NETWORK: DATA COORDINATING CTRU01HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI THOM, ELIZABETH ANN · 1998 to 2008
$27.0M
Chief Scientist Office CZG/2/575Medical Research Council G1002033NICHD NIH HHS U01 HD036801
6 · The paper itself

Abstract

backgroundIn twin pregnancies, the rates of adverse perinatal outcome and subsequent long-term morbidity are substantial, and mainly result from preterm birth (PTB).

objectivesTo assess the effectiveness of progestogen treatment in the prevention of neonatal morbidity or PTB in twin pregnancies using individual participant data meta-analysis (IPDMA). SEARCH STRATEGY: We searched international scientific databases, trial registration websites, and references of identified articles. SELECTION CRITERIA: Randomised clinical trials (RCTs) of 17-hydroxyprogesterone caproate (17Pc) or vaginally administered natural progesterone, compared with placebo or no treatment. DATA COLLECTION AND ANALYSIS: Investigators of identified RCTs were asked to share their IPD. The primary outcome was a composite of perinatal mortality and severe neonatal morbidity. Prespecified subgroup analyses were performed for chorionicity, cervical length, and prior spontaneous PTB. MAIN

resultsThirteen trials included 3768 women and their 7536 babies. Neither 17Pc nor vaginal progesterone reduced the incidence of adverse perinatal outcome (17Pc relative risk, RR 1.1; 95% confidence interval, 95% CI 0.97-1.4, vaginal progesterone RR 0.97; 95% CI 0.77-1.2). In a subgroup of women with a cervical length of ≤25 mm, vaginal progesterone reduced adverse perinatal outcome when cervical length was measured at randomisation (15/56 versus 22/60; RR 0.57; 95% CI 0.47-0.70) or before 24 weeks of gestation (14/52 versus 21/56; RR 0.56; 95% CI 0.42-0.75). AUTHOR'S

conclusionsIn unselected women with an uncomplicated twin gestation, treatment with progestogens (intramuscular 17Pc or vaginal natural progesterone) does not improve perinatal outcome. Vaginal progesterone may be effective in the reduction of adverse perinatal outcome in women with a cervical length of ≤25 mm; however, further research is warranted to confirm this finding.

Indexed as

Pregnancy, Twin17 alpha-Hydroxyprogesterone CaproateAdministration, IntravaginalAdultBronchopulmonary DysplasiaCerebral HemorrhageCervical Length MeasurementCervix UteriEnterocolitis, NecrotizingFemaleHumansHydroxyprogesteronesInfant, NewbornInfant, Newborn, DiseasesPerinatal DeathPregnancy17 alpha-Hydroxyprogesterone CaproateHydroxyprogesteronesProgesteroneProgestins17-Hydroxyprogesterone caproateindividual participant data meta-analysispreterm birthtwin pregnancyvaginal progesterone

Identifiers

PMID25145491
PMCPMC5909188
OpenAlexW2080607325

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.