The Influence of Oral Dydrogesterone and Vaginal Progesterone on Threatened Abortion: A Systematic Review and Meta-Analysis
Table 3
GRADE evidence profiles: risk of miscarriage in pregnant women experiencing threatened abortion based on the route of progesterone administration.
(a) Progesterone agents versus control treatments
Quality assessment
Number of patients (%)
Absolute effect (95% CI)
Relative effect (95% CI)
Quality
Importance
No. of studies
Study design
Risk of bias
Inconsistency
Indirectness
Imprecision
Publication bias
Progesterone agents
Control
Progesterone agents
Control
Outcome: miscarriage
Progesterone versus control
7
Randomized trials
Serious
Not serious
Not serious
Serious
None
52/399 (13.0)
82/378 (21.7)
128 per 1000
217 per 1000
OR 0.53 (0.36 to 0.78)
⨁⨁◯◯ Low
Critical
89 fewer per 1,000 (from 39 fewer to 126 fewer)
Oral dydrogesterone versus control
3
Randomized trials
Serious
Not serious
Not serious
Serious
None
30/256 (11.7)
53/235 (22.6)
112 per 1000
226 per 1000
OR 0.43 (0.26 to 0.71)
⨁⨁◯◯ Low
Critical
114 fewer per 1,000 (from 54 fewer to 155 fewer)
Vaginal progesterone versus control
4
Randomized trials
Not serious
Not serious
Not serious
Not serious
None
22/143 (15.4)
29/143 (20.3)
155 per 1000
203 per 1000
OR 0.72 (0.39 to 1.34)
⨁⨁⨁⨁ High
Critical
48 fewer per 1,000 (from 51 more to 113 fewer)
CI: confidence interval; OR: odds ratio; either the participants or personnel were not blinded in these studies (performance bias); the 95% CI includes appreciable harm or benefit.
(b) Oral dydrogesterone versus vaginal progesterone
Quality assessment
Number of patients (%)
Absolute effect (95% CI)
Relative effect (95% CI)
Quality
Importance
No. of studies
Study design
Risk of bias
Inconsistency
Indirectness
Imprecision
Publication bias
Oral dydrogesterone
Vaginal progesterone
Oral dydrogesterone
Vaginal progesterone
Outcome: miscarriage
2
Randomized trials
Serious
Not serious
Not serious
Serious
None
12/70 (17.1)
11/66 (16.7)
175 per 1000
167 per 1000
OR 1.06 (0.42 to 2.66)
⨁⨁◯◯ Low
Critical
8 more per 1,000 (from 89 fewer to 181 more)
CI: confidence interval; OR: odds ratio; limited information was available because a study was only published in abstract form.
