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[Correspondence] Vaginal progesterone prophylaxis for preterm birth

The OPPTIMUM study1 is an ambitious effectiveness trial of natural progesterone supplementation to prevent preterm birth. First, before initiation of the trial, evidence of a positive treatment response had not been well established for the subgroup enrolled with a positive fetal fibronectin test. Second, regarding the biggest subgroup, women with a history of spontaneous preterm birth, the largest trial published before OPPTIMUM that tested this medication in singleton pregnancies similarly did not show a benefit.