Does Progesterone Prevent Very Preterm Delivery in Twin Pregnancies?

NCT ID: NCT00329914

Last Updated: 2011-07-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

677 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-06-30

Study Completion Date

2010-09-30

Brief Summary

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The purpose of the study is to determine whether a daily dose of 200 mg progesterone administered vaginally from 20-23 to 34 weeks' gestation will reduce the rate of preterm delivery amongst twin pregnancies.

Detailed Description

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Multiple gestations account for 2% of all pregnancies, but cause more than 10% of the cases of preterm delivery. Due to increasing maternal age and use of assisted reproduction the number of multiple gestations is larger than ever. If markers of preterm delivery can be identified and means of preventing preterm delivery are found, it will be possible to reduce the number of children admitted to hospital because of prematurity.

Recently, two larger randomised studies investigated the effect of progesterone in singleton pregnancies of women who had previously delivered preterm. They both found a significant reduction in the preterm delivery rate in the progesterone group compared to a placebo group.

The study will be performed as a randomized, double-blind placebo controlled study of twin pregnancies in Denmark and Austria. The women will be randomised in a 1:1 ratio to two groups (progesterone versus placebo). Randomisation will be stratified per centre and according to chorionicity, as the risk of preterm delivery is doubled in monochorionic twins compared to dichorionic twins.

Conditions

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Preterm Delivery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo pessaries containing peanut oil

Progesterone

Group Type ACTIVE_COMPARATOR

Progesterone

Intervention Type DRUG

Vaginal pessaries, 200 mg/day

Interventions

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Progesterone

Vaginal pessaries, 200 mg/day

Intervention Type DRUG

Placebo

Placebo pessaries containing peanut oil

Intervention Type DRUG

Other Intervention Names

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Utrogestan

Eligibility Criteria

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Inclusion Criteria

* Twin pregnancy
* Informed consent
* 18-23 weeks' gestation
* Participants must be fluent in the language spoken in the respective centres

Exclusion Criteria

* Age \< 18 years
* Known allergy to progesterone or peanuts
* Active thromboembolic disorders or a history of hormone-associated thromboembolic disorders
* Rupture of membranes at the time of inclusion
* Monoamniotic twins
* Pregnancies treated for or with signs of twin-to-twin transfusion syndrome at inclusion
* Multiple pregnancies reduced to twin pregnancies
* Known significant structural or chromosomal fetal abnormality
* Chorionicity not assessed before 15 weeks
* Known or suspected malignancy in genitals or breasts
* Known liver disease
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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The Danish Medical Research Council

OTHER

Sponsor Role collaborator

The Danish Medical Society in Copenhagen

UNKNOWN

Sponsor Role collaborator

AP Moeller Foundation

OTHER

Sponsor Role collaborator

Rigshospitalet, Denmark

OTHER

Sponsor Role lead

Responsible Party

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Rigshospitalet

Principal Investigators

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Line Rode, MD

Role: PRINCIPAL_INVESTIGATOR

Ultrasound Clinic 4002, Rigshospitalet

Ann Tabor, professor

Role: STUDY_DIRECTOR

Ultrasound Clinic 4002, Rigshospitalet

Locations

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Graz University Hospital

Graz, , Austria

Site Status

Innsbruck University Hospital

Innsbruck, , Austria

Site Status

Klagenfurt Hospital

Klagenfurt, , Austria

Site Status

Vienna University Hospital

Vienna, , Austria

Site Status

Aalborg Hospital

Aalborg, , Denmark

Site Status

Skejby Hospital

Aarhus, , Denmark

Site Status

Rigshospitalet

Copenhagen, , Denmark

Site Status

Glostrup Hospital

Glostrup Municipality, , Denmark

Site Status

Gentofte Hospital

Hellerup, , Denmark

Site Status

Herlev Hospital

Herlev, , Denmark

Site Status

Hilleroed Hospital

Hilleroed, , Denmark

Site Status

Holbaek Hospital

Holbæk, , Denmark

Site Status

Hvidovre Hospital

Hvidovre, , Denmark

Site Status

Odense University Hospital

Odense, , Denmark

Site Status

Roskilde Hospital

Roskilde, , Denmark

Site Status

Soenderborg Hospital

Sønderborg, , Denmark

Site Status

Viborg Hospital

Viborg, , Denmark

Site Status

Countries

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Austria Denmark

References

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Rode L, Klein K, Nicolaides KH, Krampl-Bettelheim E, Tabor A; PREDICT Group. Prevention of preterm delivery in twin gestations (PREDICT): a multicenter, randomized, placebo-controlled trial on the effect of vaginal micronized progesterone. Ultrasound Obstet Gynecol. 2011 Sep;38(3):272-80. doi: 10.1002/uog.9093.

Reference Type RESULT
PMID: 21739497 (View on PubMed)

Klein K, Rode L, Nicolaides KH, Krampl-Bettelheim E, Tabor A; PREDICT Group. Vaginal micronized progesterone and risk of preterm delivery in high-risk twin pregnancies: secondary analysis of a placebo-controlled randomized trial and meta-analysis. Ultrasound Obstet Gynecol. 2011 Sep;38(3):281-7. doi: 10.1002/uog.9092.

Reference Type RESULT
PMID: 21739499 (View on PubMed)

Rode L, Klein K, Larsen H, Holmskov A, Andreasen KR, Uldbjerg N, Ramb J, Bodker B, Skibsted L, Sperling L, Hinterberger S, Krebs L, Zingenberg H, Weiss EC, Strobl I, Laursen L, Christensen JT, Skogstrand K, Hougaard DM, Krampl-Bettelheim E, Rosthoj S, Vogel I, Tabor A. Cytokines and the risk of preterm delivery in twin pregnancies. Obstet Gynecol. 2012 Jul;120(1):60-8. doi: 10.1097/AOG.0b013e31825bc3cd.

Reference Type DERIVED
PMID: 22914392 (View on PubMed)

Related Links

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Other Identifiers

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predict2006

Identifier Type: -

Identifier Source: org_study_id

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