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Could Progesterone Be the Key to Preventing Preeclampsia? New Research Sheds Light

Updated: Jan 9


Hypertensive disorders of pregnancy (HDP), such as preeclampsia, are serious pregnancy complications that affect 46.3 per 1000 Canadian pregnancies (0.463%).[1] (Public Health Agency of Canada, 2014). Preeclampsia is characterized by high blood pressure and signs of damage to other organ systems after 20 weeks of pregnancy. Preeclampsia can restrict fetal growth and lead to serious complications for both mother and baby, including eclampsia, stroke, preterm birth and even death. As such, preventing preeclampsia is an important goal in obstetric care and research.

Meta-Analysis on Progesterone’s effect on HDPs, like Preeclampsia

A recent large-scale study “Vaginal micronised progesterone for the prevention of hypertensive disorders of pregnancy”,  investigated the effect of progesterone supplementation in pregnancy on the risk of developing hypertensive disorders like preeclampsia.[2]  (Melo et al, 2023)

The study was a systematic review and meta-analysis of 11 randomized controlled trials involving a total of 11,640 women. By combining and analyzing the data across these trials, the researchers aimed to provide a robust evaluation of whether progesterone supplementation can help prevent complications like preeclampsia in pregnancy. 


Findings Summarized:

  • Reduced HDP by 29% 

  • Reduced preeclampsia by 39% 

  • If started after first trimester, progesterone made no difference in HDP or preeclampsia rates 

young woman with molecular halo surrounding her
Can progesterone provide a protective halo against HDP, including preeclampsia?

It's about timing. Findings show effectiveness of EARLY progesterone to reduce HDP 

The analysis found a 29% decrease in hypertensive disorders and a 39% reduction in preeclampsia incidence. 

As no significant difference was found in rates of HDP or preeclampsia when progesterone was started in the second or third trimesters, the timing of initiation appears to be an important factor in whether progesterone is effective.

A protective effect against preterm birth incidence is an obvious benefit, as the only way to correct HDPs, like preeclampsia, is delivery.

How It Might Work: Proposed Mechanism of Action

As no significant difference was found in rates of HDP or preeclampsia when progesterone was started in the second or third trimesters. The timing of initiation appears to be an important factor in whether progesterone impacts risk.

The authors posit that progesterone supplementation in the first trimester of pregnancy may improve the implantation of the fertilized egg (zygote) which results in better placental development, mitigating the development of HDP later in pregnancy. [2]

The researchers say more research is needed on using progesterone in the first trimester to prevent HDP & preeclampsia in high-risk women, particularly those with a history of previous HDPs.

Reducing HDP & Preeclampsia

The recent systematic review provides promising but not definitive evidence that administering vaginal progesterone in the first trimester of pregnancy may significantly reduce the risk of developing hypertensive disorders like preeclampsia in some women with higher risk pregnancies. The analysis found a 29% decrease in hypertensive disorders and a 39% reduction in preeclampsia incidence. 


More research is still required, especially focused on using progesterone to prevent preeclampsia in women at high-risk of developing the condition. The available data indicates vaginal progesterone in the first trimester could become a safe, non-invasive strategy to reduce preeclampsia risk.


The UK main research center for this work is Tommys.org Their announcement of these study findings can be found here.[4] (Tommy's, 2023).



Written by Carolyn Plican, Creighton Model FertilityCare Practitioner

Reviewed by Dr. Mary Ellen Haggerty, Restorative Reproductive Medicine Clinician


[1] Public Health Agency of Canada. (2014). Maternal hypertension in Canada. Government of Canada. Retrieved October 9, 2014, from https://www.canada.ca/en/public-health/services/publications/healthy-living/maternal-hypertension-canada.html


[2] Melo, P.; Devall, A.; Shennan A.H.; Vatish, M.; Becker, C.M.; Granne, I.; Papageorghiou, A.T.; Mol, B. & Coomarasamy, A. (2023) Vaginal micronised progesterone for the prevention of hypertensive disorders of pregnancy: A systematic review and meta-analysis, BJOG, https://doi.org/10.1111/1471-0528.17705


[3] Tommy's. (2023, November 8). Giving progesterone in the first trimester could reduce preeclampsia risk 39%, say Tommy's researchers. Tommy's News & Views. https://www.tommys.org/about-us/news-views/giving-progesterone-first-trimester-could-reduce-preeclampsia-risk-39



Written by Carolyn Plican, Creighton Model FertilityCare Practitioner

Reviewed by Dr. Mary Ellen Haggerty, Restorative Reproductive Medicine Clinician

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