Comparison of Vaginal Progesterone Alone with Vaginal Progesterone in Combination with Alpha Lipoic Acid for Prevention of Preterm Birth

Background: The etiology of preterm labor is complicated. Fetal membrane activation, cervical abnormalities, abdominal pain, and spontaneous uterine contractions are all associated with an inflammatory response. Premature birth is closely connected with cervical shortening throughout the second quarter of pregnancy. We assessed the advantages of administering alpha lipoic acid to women who were deemed to be at risk of preterm delivery due to a history of preterm birth. Methods: Patients presenting at the Gynecology and Obstetrics Department, Allied Hospital, Faisalabad from Sep 2024 to 28 Feb 2025 were included in this prospective study. Group A patients were given vaginal suppository of micronized progesterone alone (Cyclogest 400 mg vaginal pessary) nightly before bedtime until delivery. Group B patients were given vaginal progesterone in combination with oral alpha lipoic acid; Cyclogest 400 mg vaginal pessary with 2 tablets Alapro (containing 300 mg alpha lipoic acid) daily until delivery. Efficacy of the treatment was assessed by the absence /presence of preterm births. Results: Among 140 pregnant females, 70 belonged to each group. In Group A, 66 patients delivered after 37 weeks while in Group B, 56 patients delivered after 37 weeks. (p-value <0.05). Conclusion: In our group of patients, oral alpha lipoic acid supplementation with vaginal progesterone was more efficacious than vaginal progesterone alone at preventing premature birth. During the course of treatment, no negative effects were found.