Does Natural Micronized Progesterone Prevent Preterm Labor?: Systematic Literature Review
Abstract
Introduction. Progesterone is a hormone that favors maintaining pregnancy. It is the protagonist of the physiopathology of preterm labor. In this sense, a systematic review is proposed to demonstrate the usefulness of natural micronized progesterone in mitigating the harmful effects of preterm labor. Methodology. A systematic review in which the terms “MeSH” and “No – MeSH” were used. The “Publish or Perish” program was used, as well as databases, such as: Medline, PubMed, Embase, Clinical Key, Cochrane Library, Scopus, and Google Scholar. Review and meta-analysis articles, original articles (preliminary or complete publications), congress summaries, published seminars, textbooks, regional hospital protocols and national consensuses were included, in which each author individually assessed each article and applied the CASPE tool. Results. It was not possible to find concise international guidelines on using micronized progesterone for the threat of preterm labor (PTL) in literature. According to what the authors analyzed, for the mitigation of labor it is generally recommended the use of natural micronized progesterone in 100 to 400 mg/day capsules orally or 100 to 200 mg every 12 to 24 hours through the vagina. From week 16 to week 36 of pregnancy orally and from week 24 to 34 through the vagina. Discussion. Using micronized progesterone has demonstrated mitigating complications subsequent to preterm labor. However, there is no consensus on dosage and routes of administration. Added to the above, the analyzed studies may contain biases, reason why using this medication is left to the physician’s discretion. Conclusions. Natural micronized progesterone can be used to mitigate preterm labor according to the articles the authors analyzed throughout the review. However, more studies are needed to validate this hypothesis.
References
Challis JRG, Matthews SG, Gibb W, Lye SJ. Endocrine and Paracrine Regulation of Birth at Term and Preterm. Endocrine Reviews [Internet]. 2000;21(5):514-550. doi: https://doi.org/10.1210/edrv.21.5.0407
Brown AG, Leite RS, Strauss JF. Mechanisms Underlying “Functional” Progesterone Withdrawal at Parturition. Ann New York Acad Sci [Internet]. 2004;1034(1):36-49. doi: https://doi.org/10.1196/annals.1335.004
Ríos L, Nova N. Guía de manejo de Trabajo de Parto Pretérmino en el Hospital Local del Norte – E.S.E ISABU, 2018.
World Health Organization (WHO). Global Preterm Birth Estimates [Internet]. WHO; 2018. Recuperado a partir de: https://ptb.srhr.org/
Centro Nacional de Investigación en Evidencia y Tecnologías en Salud CINETS. Guías de Práctica Clínica para la prevención, detección temprana y tratamiento de las complicaciones del embarazo, parto o puerperio [Internet]. 2013;Guías11-15. Recuperado a partir de: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/INEC/IETS/Gu%C3%ADa.completa.Embarazo.Parto.2013.pdf
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Loannidis JPA, et al. The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies that Evaluate Health Care Interventions: Explanation and Elaboration. PLoS Med [Internet]. 2009;62(7):e1–34. doi: https://doi.org/10.1371/journal.pmed.1000100
Shah NM, Lai PF, Imami N, Johnson MR. Progesterone-Related Immune Modulation of Pregnancy and Labor. Front. Endocrinol [Internet]. 2019;10. doi: https://doi.org/10.3389/fendo.2019.00198
Grazzini E, Guillon G, Mouillac B, Zingg HH. Inhibition of oxytocin receptor function by direct binding of progesterone. Nature [Internet]. 1998;392(6675):509-512. doi: https://doi.org/10.1038/33176
Guoyang Luo, Abrahams VM, Tadesse S, Funai EF, Hodgson EJ, Gao J, et al. Progesterone Inhibits Basal and TNF-α-Induced Apoptosis in Fetal Membranes: A Novel Mechanism to Explain Progesterone-Mediated Prevention of Preterm Birth. Reproductive Sciences [Internet]. 2010;17(6):532-539. doi: https://doi.org/10.1177/1933719110363618
Blondel B, Macfarlane A, Gissler M, Breart G, Zeitlin J. General obstetrics: Preterm birth and multiple pregnancy in European countries participating in the PERISTAT project. BJOG: An International Journal of Obstetrics & Gynaecology [Internet]. 2006;113(5):528-535. doi: https://doi.org/10.1111/j.1471-0528.2006.00923.x
Mendoza-Tascón LA, Claros-Benítez DI, Mendoza-Tascón LI, Arias-Guatibonza MD, Peñaranda-Ospina CB. Epidemiología de la prematuridad, sus determinantes y prevención del parto prematuro. Rev. chil. obstet. ginecol [Internet]. 2016 [citado 11 de febrero de 2022];81(4):330-342. doi: http://dx.doi.org/10.4067/S0717-75262016000400012
Orizaba-Chávez B, Alba-Jasso GA, Ocharán-Hernández ME. Farmacocinética de la progesterona. Rev. Hosp. Jua. Mex [Internet]. 2013;80(1):59-66. Recuperado a partir de: https://www.medigraphic.com/pdfs/juarez/ju-2013/ju131j.pdf
Schering-Plough Research Institute. Product information: PROMETRIUM® (progesterone, USP) Capsules 100 mg [Internet]. Recuperado a partir de: https://www.accessdata.fda.gov/drugsatfda_docs/label/1998/20843lbl.pdf
Hassan SS, Romero R, Vidyadhari D, Fusey S, Baxter J, Khandelwal M, et al. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol [Internet]. 2011;38(1):18-31. doi: https://doi.org/10.1002/uog.9017
Dodd JM, Jones L, Flenady V, Cincotta R, Crowther CA. Prenatal administration of progesterone for preventing preterm birth in women considered to be at risk of preterm birth. Cochrane Database Syst Rev [Internet]. 2013;7:CD004947. doi: https://doi.org/10.1002/14651858.CD004947.pub3
Fonseca EB, Celik E, Parra M, Singh M, Nicolaides KH. Progesterone and the Risk of Preterm Birth among Women with a Short Cervix. N Engl J Med [Internet]. 2007;357(5):462–9. doi: https://doi.org/10.1056/NEJMoa067815
Cetingoz E, Cam C, Sakallı M, Karateke A, Celik C, Sancak A. Progesterone effects on preterm birth in high-risk pregnancies: a randomized placebo-controlled trial. Arch Gynecol Obstet [Internet]. 2010;283:423–9. doi: https://doi.org/10.1007/s00404-009-1351-2
Rai P, Rajaram S, Goel N, Ayalur-Gopalakrishnan R, Agarwal R, Mehta S. Oral micronized progesterone for prevention of preterm birth. Int J Gynecol Obstet [Internet]. 2009;104(1):40-43. doi: https://doi.org/10.1016/j.ijgo.2008.08.029
Baumbach J, Shi SQ, Shi L, Balducci J, Coonrod DV, Garfield RD. Inhibition of uterine contractility with various tocolytics with and without progesterone: in vitro studies. Am J Obstet Gynecol [Internet]. 2012;206(3):254.e1-254.e5. doi: https://doi.org/10.1016/j.ajog.2011.12.011
Choudhary M, Suneja A, Vaid NB, Guleria K, Faridi MMA. Maintenance tocolysis with oral micronized progesterone for prevention of preterm birth after arrested preterm labor. Int J Gynaecol Obstet [Internet]. 2014;126(1):60-3 doi: https://doi.org/10.1016/j.ijgo.2014.01.019
Glover MM, McKenna DS, Downing CM, Smith DB, Croom CS, Sonek JD. A Randomized Trial of Micronized Progesterone for the Prevention of Recurrent Preterm Birth. Am J Perinatol [Internet]. 2011;28(5):377-81. doi: https://doi.org/10.1055/s-0031-1274509
Asociación Española de Pediatría (AEP). Progesterona natural micronizada. Pediamécum AEP [Internet]. Recuperado a partir de: https://www.aeped.es/comite-medicamentos/pediamecum/progesterona-natural-micronizada
Organización Mundial de la Salud (OMS). Metas mundiales de nutrición 2025: Documento normativo sobre bajo peso al nacer [Internet]. OMS;2020. Recuperado a partir de: https://www.who.int/es/publications/i/item/WHO-NMH-NHD-14.5
Molina-Giraldo S, Buitrago-Leal M, Benavides-Serralde JA, Cardona-Ospina A, Puccini-Santamaría G, Lavalle-López OD, et al. Consenso de la Federación Colombiana de Asociaciones de Perinatología y Medicina Materno Fetal (FECOPEN) para el uso de Progesterona Natural Micronizada en parto pretérmino, Bogotá-2018. Federación Colombiana de Asociaciones de Perinatología y Medicina Materno Fetal (FECOPEN) [Internet]. 2018. Recuperado a partir de: https://fecopen.org/wp-content/images/CONSENSO_PROGESTERONA_NATURAL.pdf
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