Replies to a questionnaire Nationwide status of progestogen treatment to prevent spontaneous preterm birth: A questionnaire survey for childbirth healthcare facilities in Japan.xlsx

Nationwide status of progestogen treatment to prevent spontaneous preterm birth: A questionnaire survey for childbirth healthcare facilities in JapanAim: This study aimed to investigate the current status of progestogen treatment for pregnant women at a high risk for preterm birth in childbirth healthcare facilities in Japan.Methods: A web-based nationwide questionnaire survey regarding progestogen use for prevention of preterm birth was conducted among childbirth healthcare facilities from 2019 to 2021.Results: Valid responses were obtained from 528 facilities (25.2% of those surveyed), including 155 tertiary perinatal facilities (making up 92.3% of all perinatal care facilities). In the survey period, progestogen treatment was implemented in 207 facilities (39.2%) for preterm birth prevention. Regarding types of progestogens, 17α-hydroxyprogesterone caproate was used in 181 facilities (87.4%), with a low dose (125 mg/week) administered in 56.9% of the facilities to comply with the regulations of the national health insurance system, although 250 mg/week is considered the best dose. Vaginal progesterone was used in 32 facilities (15.4%), although the cost of vaginal progesterone was not covered by health insurance. Of the facilities not administering progestogen treatment, approximately 40% expressed that vaginal progesterone would be their first choice for preterm birth prevention in daily practice if it would be covered by health insurance in the future.Conclusions: Due to the current regulations of the Japanese health insurance system, 17α-hydroxyprogesterone caproate, rather than vaginal progesterone, was mainly used for preterm birth prevention. Despite global evidence supporting vaginal progesterone as the approach with the highest efficacy, only a limited number of facilities have utilized it due to the current drug use regulations in Japan.