Check, J. H., Lee, G., Epstein, R., & Vetter, B. (1992). Increased rate of preterm deliveries in untreated women with luteal phase deficiencies. Preliminary report. Gynecologic and Obstetric Investigation, 33(3), 183-184. https://doi.org/10.1159/000294877
Check JH, Lee G, Epstein R, Vetter B. Increased rate of preterm deliveries in untreated women with luteal phase deficiencies. Preliminary report. Gynecol Obstet Invest. 1992;33(3):183-184. doi:10.1159/000294877
Check, Jerome H., et al. "Increased rate of preterm deliveries in untreated women with luteal phase deficiencies. Preliminary report." Gynecologic and Obstetric Investigation, vol. 33, no. 3, 1992, pp. 183-184.
More preterm births in luteal phase defect women given no progesterone
A retrospective cohort study followed 540 women with luteal phase defects and one baby each, comparing progesterone in early pregnancy with none. About 31 out of 100 untreated women delivered preterm, versus 14 out of 100 treated. Treated means at least 12 weeks of progesterone. Preterm means before 37 weeks.
Key Findings
Deliveries before 37 weeks: 10 of 32 women with no progesterone (31.2%) and 64 of 469 with at least 12 weeks of progesterone (13.7%), p < 0.01.
The group with progesterone for more than 6 but fewer than 10 weeks had 4 of 39 deliveries before 37 weeks (10.3%). Against the no-progesterone group, p = 0.06.
Deliveries before 32 weeks: 4 of 32 with no progesterone (12.5%) and 6 of 469 with at least 12 weeks of progesterone (1.3%), p < 0.01.
Under 2,500 g: 4 of 32 with no progesterone (12.5%), 43 of 469 with 12 weeks or more (9.2%), 6 of 39 with a shorter course (15.4%). No statistical differences.
Fetal anomalies in progesterone-treated women were no greater than the 2.6% expected in the normal population.
Interpretation
This retrospective cohort study followed women with primary infertility and a luteal phase defect confirmed by endometrial biopsy. All were pregnant with one baby. Progesterone given for at least 12 weeks in early pregnancy was linked with fewer preterm births, fewer very preterm births, and no rise in fetal anomalies. The authors note the retrospective design and call for a prospective randomized trial. The findings support larger, randomized studies of progesterone support in these pregnancies.
RRM Context
Restorative reproductive medicine treats luteal phase function as part of cycle health. The women in this study had primary infertility and a luteal phase defect found by endometrial biopsy. They received progesterone support once pregnant. The restorative approach finds and treats the hormonal cause early, before pregnancy complications appear.
Our editorial summary of this paper, not the article's abstract.
Abstract
Some randomized studies have suggested a significant beneficial effect of 17-hydroxyprogesterone caproate in the prevention of preterm labor [1, 2]. The therapy in both studies was initiated at approximately 12-16 weeks and continued until labor. We considered the possibility that a deficient progesterone effect during the first trimester may lead to a higher rate of preterm deliveries. A retrospective study was thus performed comparing the incidence of preterm versus full-term pregnancies in women with luteal phase defects who were either treated or not treated with progesterone supplementation during the first trimester.
