SMFM Statement: Response to EPPPIC and considerations of the use of progestogens for the prevention of preterm birth

An individual participant data (IPD) meta-analysis, “Evaluating Progestogens for Preventing Preterm birth International Collaborative (EPPPIC): meta-analysis of individual participant data from randomized controlled trials,” was published in The Lancet on March 27, 2021. 1 Including 31 trials with data from 11,644 women and 16,185 offspring, the IPD meta-analysis compared vaginal progesterone, injectable 17-alpha hydroxyprogesterone caproate (17-OHPC), and oral progesterone with no treatment, or with each other, in asymptomatic women at risk of preterm birth (PTB). Data from the Progestin’s Role in Optimizing Neonatal Gestation (PROLONG) trial were included in this meta-analysis. Outcomes included PTB (<37 weeks of gestation), early PTB (<34 weeks of gestation), and mid-trimester birth (<28 weeks of gestation). Adverse neonatal outcomes associated with PTB and adverse maternal outcomes were investigated as a composite and individually. 

Click here to access the ACOG Practice Advisory, Clinical Guidance for the Integration of the Findings of the EPPPIC Meta-Analysis: Evaluating Progestogens for Preventing Preterm Birth International Collaborative.