Hormone Gel Is Said to Reduce Risk of Premature Birth

“This is a big advance,” said Dr. Mary D’Alton, the chairwoman of the department of obstetrics and gynecology at Columbia University.

Premature birth is the leading cause of death and illness among newborns. An estimated 12.9 million babies worldwide, 500,000 of them in the United States, are born prematurely every year.

In the United States, about a third of early births result from decisions by doctors that the health of either the mother or child is threatened enough to end thepregnancyearly, usually with aCaesarean section. But two-thirds of those early births are spontaneous, and any intervention that could reduce them could have significant public health consequences.

The hormone treatment, aprogesteronegel inserted vaginally every day during the second half of a pregnancy, reduced the risk of premature birth in women with a short cervix, which can soften too early.

Dr. Roberto Romero, chief of theperinatology research branchat theNational Institutes of Health, estimated that as many as 2 percent of the nation’s 500,000 annual preterm births could be prevented, leading 10,000 more babies a year to be born at full term. Screening all pregnant women and treating those found to have short cervixes would save the nation’s health system $12 million a year, Dr. Romero said.

In the study, researchers financed by the federal government gave sonograms to more than 32,000 women who were about halfway through their pregnancies. Doctors found about 465 women in that group whose cervix was unusually short. Half were treated with vaginal progesterone and the other half got a placebo.

Using the progesterone gel, which is relatively easy for women to administer to themselves, led to a 45 percent reduction in the rate of preterm birth before 33 weeks of gestation, and it led to improved outcomes for babies. Fourteen women with unusually short cervixes would need to be treated to prevent one preterm birth, the study found.

Dr. Sonia Hassan, director of theCenter for Advanced Obstetrical Care and Researchat the National Health Institutes, a co-author of the study, said the study’s findings should lead all women to have sonograms around the 20th week of their pregnancies to see if they have short cervixes that put their pregnancies at increased risk.

“The important thing is to screen all pregnant women,” Dr. Hassan said.

Dr. Gary Hankins, chairman of the department of obstetrics and gynecology at the University of Texas Medical Branch, said the study offered great hope for many women.

“If we can delay birth by just a few weeks, that can make a massive difference,” Dr. Hankins said.

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