Use of progesterone to prevent preterm birth at a tertiary care center.
OBJECTIVE
To assess the prescription patterns of progesterone for the prevention of preterm birth in a tertiary center.


METHODS
We examined electronic medical records for all women receiving care in the high risk obstetric clinics at a tertiary care center from July 2003 to June 2004. Demographic information, progesterone offers, progesterone therapy accepted and received, and barriers to receiving progesterone were collected. Women were placed into 1 of 4 categories: appropriate offer, appropriate nonoffer, inappropriate offer and inappropriate nonoffer.


RESULTS
Five hundred two patients sought prenatal care in the clinics during the study period. Of 143 women with a prior preterm birth, 60 (42%) were considered to be candidates for progesterone. Of these, 34 of 60 (57%) were offered progesterone therapy (appropriate offer). Of the 442 women who were not appropriate progesterone candidates, 9 (2%) were offered progesterone (inappropriate offer).


CONCLUSIONS
Our data suggest that a substantial proportion of eligible women are not being offered progesterone for the prevention of preterm birth. More data are needed regarding barriers to progesterone use and what programs may best influence physicians to use progesterone appropriately.
Bailit
Jennifer L
JL
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109, USA. jbailit@metrohealth.org
Berkowitz
Richard
R
Thorp
John M
JM
Cleary
Kirsten
K
Hartmann
Katherine E
KE
Mercer
Brian M
BM
D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D009774:Obstetrics / Q000592:standards*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D047928:Premature Birth / Q000517:prevention & control*; D011374:Progesterone / Q000627:therapeutic use*; D011372:Progestins / Q000627:therapeutic use*; D012307:Risk Factors
D011372:Progestins; D011374:Progesterone