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Progesterone Does Not Appear to Prevent Twin Preterm Birth

Vaginally administered hormone has no impact on rate of intrauterine death or preterm delivery

THURSDAY, June 11 (HealthDay News) -- Vaginally administered progesterone has no impact on the rate of intrauterine death, delivery before 34 weeks, or adverse events in women with twin pregnancies, according to a study published online June 11 in The Lancet.

Jane E. Norman, M.D., of the University of Edinburgh in the United Kingdom, and colleagues conducted a study of 500 women with twin pregnancies, half of whom were randomized to receive a 10-week course of 90 milligrams a day of vaginal progesterone while the other half received placebo. The researchers also conducted a meta-analysis of existing data on prevention of preterm birth and intrauterine death among women with twin pregnancies.

There were 247 women in both groups who completed the study, and the rate of intrauterine death or delivery before 34 weeks' gestation was 24.7 percent in the progesterone group and 19.4 percent in the control group, the investigators discovered. There was no difference between the two groups in terms of adverse events.

"Our results contrast with the randomized trials and meta-analyses of high-risk singleton pregnancies in which progesterone seems to be effective in reducing preterm birth, although this reduction will only be clinically useful if accompanied by long-term improvement in the health of offspring," the authors write. "The biological mechanism by which preterm delivery occurs might be different in twin and singleton pregnancy, and this hypothesis merits further study."

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