Nationwide status of progestogen treatment to prevent spontaneous preterm birth: A questionnaire survey for childbirth healthcare facilities in Japan.

Autor: Kawabata I; Department of Obstetrics Gynecology, Nippon Medical School Hospital, Tokyo, Japan.; Japanese Organization of Prevention of Preterm Delivery (JOPP), Tokyo, Japan., Nagamatsu T; Japanese Organization of Prevention of Preterm Delivery (JOPP), Tokyo, Japan.; Department of Obstetrics Gynecology, International University of Health and Welfare Narita Hospital, Chiba, Japan., Yoneda S; Japanese Organization of Prevention of Preterm Delivery (JOPP), Tokyo, Japan.; Department of Obstetrics Gynecology, Toyama University Hospital, Toyama, Japan., Oi R; Japanese Organization of Prevention of Preterm Delivery (JOPP), Tokyo, Japan.; You Women's Clinic, Kanagawa, Japan., Matsuda Y; Japanese Organization of Prevention of Preterm Delivery (JOPP), Tokyo, Japan.; Toho Women's Clinic, Tokyo, Japan., Nakai A; Japanese Organization of Prevention of Preterm Delivery (JOPP), Tokyo, Japan.; Department of Obstetrics Gynecology, Nippon Medical School Tamanagayama Hospital, Tokyo, Japan., Otsuki K; Japanese Organization of Prevention of Preterm Delivery (JOPP), Tokyo, Japan.; Department of Obstetrics Gynecology, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Jazyk: angličtina
Zdroj: The journal of obstetrics and gynaecology research [J Obstet Gynaecol Res] 2024 May; Vol. 50 (5), pp. 873-880. Date of Electronic Publication: 2024 Feb 18.
DOI: 10.1111/jog.15909
Abstrakt: Aim: This study aimed to investigate the current status of progestogen treatment for pregnant women at a high risk for preterm birth (PTB) in childbirth healthcare facilities in Japan.
Methods: A web-based nationwide questionnaire survey regarding progestogen use for prevention of PTB was conducted among childbirth healthcare facilities from 2019 to 2021.
Results: Valid responses were obtained from 528 facilities (25.2% of those surveyed), including 155 tertiary perinatal facilities (making up 92.3% of all tertiary perinatal care facilities). In the survey period, progestogen treatment was implemented in 207 facilities (39.2%) for PTB prevention. Regarding types of progestogens, 17α-hydroxyprogesterone caproate was used in 170 facilities (82.1%), with a low dose (125 mg/week) administered in 62.9% of the facilities to comply with the regulations of the national health insurance system, although 250 mg/week is considered the best dose. Vaginal progesterone was used in 36 facilities (17.4%), although the cost of vaginal progesterone was not covered by health insurance. Of the facilities not administering progestogen treatment, approximately 40% expressed that vaginal progesterone would be their first choice for PTB prevention in daily practice if it would be covered by health insurance in the future.
Conclusions: Due to the current regulations of the Japanese health insurance system, 17α-hydroxyprogesterone caproate, rather than vaginal progesterone, was mainly used for PTB prevention. Despite global evidence supporting vaginal progesterone as the approach with the highest efficacy, only a limited number of facilities have utilized it due to the current drug use regulations in Japan.
(© 2024 The Authors. Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.)
Databáze: MEDLINE
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