Women with a history of miscarriage could have that risk reduced if they are given the hormone progesterone, say researchers from the University of Birmingham who estimate that 4,700 babies’ lives could be saved in the UK every year.
The study involved more than 4,000 pregnant women who presented with early pregnancy bleeding at 48 UK hospitals. Half the women were given 400mg of progesterone twice daily while the other half received a placebo.
Of the 777 women given progesterone who had previously had one or two miscarriages, 591 (76%) went on to have a live birth, compared with 534 women out of 738 in the placebo group (72%).
The benefit was greater for the women who had suffered three or more miscarriages – with a 15% increase in the live birth rate in the progesterone group compared with the placebo group. Of 137 women with three or more previous miscarriages, 98 (72%) went on to have a live birth, compared with 57% (85 out of 148) of women in the placebo group.
Samantha Allen, 31, from Bradford, West Yorkshire, suffered a miscarriage in December 2015, but gave birth to her son Noah in February 2018 after taking part in the trial. “He’s now 14-months-old and he’s such a lively and incredibly bright little boy who brings us so much joy, I can’t imagine life without him,” she said.
“Of course, we’ll never know whether or not I would have miscarried if I had not taken part in the trial, or if I had been part of the group that received the placebo. Either way, I feel fortunate and happy that I did participate.”
While the study did not show that progesterone could help all women who suffered early pregnancy bleeding, it was found to help those who had suffered a previous miscarriage.
Arri Coomarasamy, professor of gynaecology at the University of Birmingham and director of Tommy’s National Centre for Miscarriage Research, said: “The role of progesterone in women with early pregnancy bleeding has been studied and debated for about 60 years, however what we have previously lacked is high-quality evidence.
“The largest study before the PRISM trial had less than 200 participants, whereas our study had more than 4,000 participants and was of very high quality, which means we can be confident in our findings.
“This treatment could save thousands of babies who may have otherwise been lost to a miscarriage. We hope that this evidence will be considered by the National Institute for Health and Care Excellence (Nice) and that it will be used to update national guidelines for women at risk of miscarriage.”
The PRISM trial, funded by the National Institute for Health Research (NIHR) and published in the New England Journal of Medicine, was the largest of its kind.