High-risk pregnancy
Use of oral NMP-SR has been evaluated across a range of high-risk
pregnancies, including but not limited to patients with a poor obstetric
history, history of preterm birth, threatened miscarriage or habitual
abortion (Table 4 ). A retrospective, multicentre, case-cohort
analysis included 185 consecutive women with a high-risk pregnancy who
received oral NMP-SR supplementation.38 The most
common indications were a history of first (n = 36, 19.5%) or second (n
= 37, 20.0%) trimester loss, short/incompetent cervix (n = 22, 11.9%),
primary (n = 22, 11.9%) or secondary (n = 12, 5.9%) prophylaxis for
preterm birth, and threatened miscarriage with/without spotting (n = 19,
10.3%). Fifty women had a history of ≥ 2 pregnancy losses (28
unexplained recurrent pregnancy loss and 22 spontaneous loss). Oral
NMP-SR was generally administered at a dose of 300 mg in women with
previous pregnancy loss, cervical risk factors, or threatened
miscarriage, and at a dose of 200–300 mg in women with a history of
preterm birth or those who had premature contractions. Treatment was
usually initiated between 16 and 26 weeks of pregnancy and continued
until 34 weeks. Mean treatment duration was 19 ± 1 weeks in patients
with cervical risk factors, 18 ± 5 weeks in cases of unexplained
recurrent pregnancy loss, and 10 ± 1 weeks in those with threatened
miscarriage. In all treated cases, pregnancy continued until 34 weeks,
with no adverse outcomes.