Can progesterone be used to predict miscarriage?

  • BMC Pregnancy Childbirth

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Maternal progesterone is higher and rises linearly in normal pregnancies.

Why this matters

  • Threatened abortion affects 15%-20% of all pregnancies.
  • Threatened abortion is a risk factor for future pregnancy complications including miscarriage, preeclampsia, preterm delivery, and preterm premature rupture of membranes.

Key results

  • Miscarriage rate was 5.4% in the normal pregnancy group and 21.5% in the threatened abortion group (P<.0001>
  • Mean serum progesterone was higher in the normal pregnancy group compared with the threatened abortion group (71.8 vs 53.6 nmol/L; P<.0001>
  • Serum progesterone increased linearly from 5 to 13 weeks in the normal pregnancy group.
  • Median progesterone was uniformly lower in the threatened abortion group converging with the normal group by 13 weeks.
  • Women with spontaneous miscarriage showed a marginal and nonsignificant increase in serum progesterone.

Study design

  • Prospective cohort study (n=929).
  • Normal pregnancies were recruited from antenatal clinics (n=450); women with threatened abortion (vaginal bleeding with normal sonographic findings between 5 and 13 weeks) were recruited from emergency walk-in clinics (n=479).
  • Maternal blood samples were taken to assess progesterone levels.
  • Funding: Ministry of Health Industry Alignment Fund Category 1 research fund. 

Limitations

  • Distribution of serum progesterone across gestations does not represent samples from the same patient.

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