Impact of the recent randomized trials on the use of progesterone to prevent preterm birth: A 2005 follow-up survey

Objective: The purpose of this study was to determine whether current attitudes regarding the use of progesterone to prevent preterm birth have changed since our last survey in 2003. Study design: We mailed a 20 question survey to 1264 board certified Maternal-Fetal Medicine specialists in the United States between February and March of 2005 asking about their use and attitudes regarding progesterone to prevent preterm birth. Results: Five hundred and seventy-two surveys were returned (response rate of 45%). In 2005, 67% of respondents used progesterone to prevent SPTB, compared to 38% in 2003 (P < .001). Among users, 38% recommended progesterone for indications other than previous SPTB. Users were more concerned about lack of insurance coverage compared to nonusers but nonusers were more concerned about safety, efficacy, need for more data, and long-term neonatal effects. Conclusion: Although the use of progesterone to prevent PTB has increased significantly since our last survey, there remain a substantial number of nonusers. Among users, many are using it for indications not yet proven in clinical trials. Current nonusers have higher levels of concerns compared to nonusers in the first survey and their major concern is the need for more data.