A Statewide Progestogen Promotion Program in Ohio

Abstract

The Ohio progestogen project was associated with a sustained reduction in singleton births before 32 weeks of gestation in Ohio.

Updates on an At-Risk Population: Late-Preterm and Early-Term Infants

“…Unfortunately, this improvement is limited to singleton pregnancies, not multiples. 15,30,31 Likewise, 17-hydroxyprogesterone has shown efficacy in women with a short cervix documented by ultrasonography. 32 Screening of women with a previous preterm birth at less than 34 weeks' gestation may identify women with a cervical length ,25 mm before 24 weeks' gestation who might potentially benefit from a cervical cerclage.…”

Using a Stakeholder Analysis to Improve Systems Modelling of Health Issues: The Impact of Progesterone Therapy on Infant Mortality in Ohio

“…One of these identified interventions is the progesterone therapy, and it will be the focus of this paper. IMR is much higher among ‘very preterm’ babies born before 32 weeks of gestation (Mathews et al ., ), and randomized trials have shown that progesterone therapy reduces the chance of preterm birth in women with prior such birth and short cervix (Meis et al ., ; Hassan et al ., ; Romero et al ., ; Dodd et al ., ; Iams et al ., ). Progesterone can be administered by injection or vaginal treatment.…”

“…Improving communication between medical providers and insurers is key in progesterone uptake (Iams et al, 2017).…”

“…Table 3 shows data on women at reproductive age, births by type of pregnancy, birth outcomes and deaths. A recent study of pregnant women on Medicaid found that 6% was eligible for progesterone therapy (Iams et al, 2017). The number of total births was approximately 65 000 from 2012 to 2015.…”

Prevention of Preterm Birth Redux: Progesterone Works

“…What we discuss in this commentary is the use of weekly 17P injection in women with a singleton gestation who have had a prior spontaneous preterm birth. A recent study by Iams et al [13] revealed that in clinics of 20 large hospitals in Ohio, over 2500 women eligible for 17P were tracked for almost two years and there was a 13% reduction in births before 32 weeks, which is exactly the group where most of the neonatal morbidity and mortality would occur. The foundation of this successful program emphasizes early access to prenatal care, consistent counselling regarding early recognition of preterm labor, adopting a cervical length sonography screening program as well as expediting weekly progesterone supplementation and customizing the start of such treatment in each case.…”