title: Vaginal progesterone to prevent preterm birth in multiple pregnancy: a randomized controlled trial.
abstract: OBJECTIVE
  We sought to assess the effect of progesterone in increasing or decreasing duration of pregnancy for mothers with twins and triplets.
  
  
  METHODS
  Women with multiple pregnancy were randomized at 16+0 to 20+6 weeks' gestation to receive daily doses of either 90 mg progesterone vaginal gel or placebo until 35+6 weeks or delivery. Primary outcome was gestational age (GA) at delivery. Secondary outcomes included preterm birth, infant morbidity and mortality, and adverse events up to 28 days after delivery. A sample size of 40 per group was required to detect a 2-week difference in GA at delivery.
  
  
  RESULTS
  Eighty-four women were randomized (42 to progesterone, 42 to placebo). Median GA at delivery was 36+3 and 36+2, respectively (difference, 1 day; 95% confidence interval, 4 to -1 days, P=0.585). There were no clinically or statistically significant differences between groups for risk of delivery before 35 or 37 weeks' GA, rates of infant morbidity and mortality, treatment compliance, or adverse events.
  
  
  CONCLUSIONS
  Daily treatment with progesterone gel did not prolong multiple pregnancy compared with placebo. Effective prevention strategies are needed to reduce preterm deliveries among women with multiple gestations.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wood
authors.forename: Sue
authors.initials: S
authors.lastname: Ross
authors.forename: Selphee
authors.initials: S
authors.lastname: Tang
authors.forename: Leslie
authors.initials: L
authors.lastname: Miller
authors.forename: Reg
authors.initials: R
authors.lastname: Sauve
authors.forename: Rollin
authors.initials: R
authors.lastname: Brant
mesh_terms: D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D047928:Premature Birth / Q000517:prevention & control; D011374:Progesterone; D011372:Progestins
chemical_list: D011372:Progestins; D011374:Progesterone