Interventions to prevent spontaneous preterm birth in women with singleton pregnancy who are at high risk: systematic review and network meta-analysis.

Summary

This systematic review and Bayesian network meta-analysis of 61 randomised trials (17,273 women) compares interventions to prevent spontaneous preterm birth in women with a singleton pregnancy at high risk because of a previous spontaneous preterm birth or short cervical length. Interventions compared include bed rest, cervical cerclage, cervical pessary, omega fatty acids, zinc, progesterone by various routes, prophylactic antibiotics and tocolytics. Maternal and fetal outcomes were analysed in line with core outcomes for preterm birth research. The authors conclude that vaginal progesterone should be considered the preventative treatment of choice and used as the comparator in future trials.

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