Progestogen Prescribing Patterns Before and During Pregnancy in Italy: A Secondary Analysis of Population-Based Data from the MoM-Net Network

Background/Objectives: Progesterone is commonly prescribed during pregnancy for selected obstetric indications, but population-based evidence on prescribing patterns and their consistency with current recommendations remains limited. This study aimed to describe progestogen prescribing patterns in Italy before and during pregnancy and assess variability by maternal characteristics and geographic area. Methods: We conducted a population-based retrospective cohort study of women who gave birth between 1 April 2016 and 31 March 2018 in eight Italian regions, using data from the Monitoring Medications Use During Pregnancy Network (MoM-Net), integrating birth registry and outpatient prescription claims data. This study is a secondary analysis of the aggregated results of the MoM-Net national report. Descriptive statistics characterized progestogen prescriptions overall and by trimester, history of miscarriage, type of pregnancy, maternal age, and region of residence. Results: The study included 449,012 women (approximately 59% of all Italian births in the study period). Overall, 20.2% received at least one progestogen prescription. Use increased from 3.0% in the trimester before conception to 15.3% in the first trimester, then declined to 7.0% and 3.8% in the second and third trimesters, respectively. Prescribing was higher among women with at least 2 previous miscarriages, in multiple versus singleton pregnancies (50.8% vs. 19.6%), and increased with maternal age (17.0% in women ≤34 years, 22.9% in those aged 35–39 and 33.2% in those aged ≥40 years). Interregional variability was marked. Conclusions: Progestogen prescribing during pregnancy in Italy in 2016–2018 was common and varied substantially across maternal subgroups and regions. Observed rates were higher than the expected prevalence of the main evidence-supported indications; however, in the absence of individual clinical data, appropriateness could not be assessed. Further studies are needed to better understand these prescribing patterns.