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Clinical Obstetrics

Poster Session 2

(620) Childhood outcomes of multiples prenatally exposed to progesterone for the prevention of preterm birth

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Progesterone is extensively used in pregnancy for the prevention of preterm birth in high risk women. We assessed the long-term effect of prenatal progesterone exposure versus placebo on child development and behaviour until early adolescence.

Study Design: This study is a follow-up of the AMPHIA randomized controlled trial which assessed weekly intramuscular injections starting at 16 weeks of gestation of 250 mg 17-alpha-hydroxyprogesterone caproate (17-OHPC, n=336 women; 681 children) compared to placebo (n=335 women; 674 children) to prevent adverse neonatal outcome in multiple pregnancies. In this follow-up study children were assessed through parental, self-reported and teacher questionnaires at 11-14 years of age. Main outcome of interest were cognition, behaviour, mortality, gender identity, general health and a composite of mortality or survival with abnormal development.

Results: In total 60 children deceased, 24 (3.7%) in 17-OHPC group versus 36 (5.6%) in the placebo group (OR 0.66, 95%CI 0.39-1.11). Developmental outcomes were collected for 303 of 1296 (23%) surviving children. No differences between 17-OHPC and placebo group were measured regarding child’s cognition, behaviour, mortality, gender identity and general health up to 14 years of age. A composite of abnormal development or mortality did not differ between progesterone (9.5%) and placebo (10.1%) groups (OR 0.93, 95% CI 0.65-1.35).

Conclusion: Mortality or neurodevelopmental disability of children exposed in utero to 17-OHPC compared to placebo during the second and third trimester of pregnancy does not differ between groups at 11-14 years of age.