Serum Progesterone and Threatened Abortion During Lactation

This study is designed to investigate the relationship between maternal serum progesterone levels and threatened abortion in women who conceive during the lactation period. The primary objective is to evaluate first-trimester serum progesterone concentrations in lactating pregnant women and to assess their role in the etiology and clinical course of threatened abortion.

Threatened abortion is characterized by vaginal bleeding during the first trimester of pregnancy and is associated with an increased risk of early pregnancy loss. Progesterone plays a critical role in the maintenance of early pregnancy by supporting endometrial receptivity, suppressing uterine contractility, and modulating maternal immune tolerance. Previous studies have demonstrated that serum progesterone levels tend to be lower in pregnancies complicated by threatened abortion compared to uncomplicated pregnancies, and that reduced progesterone concentrations may be predictive of subsequent miscarriage.

Lactation is associated with distinct hormonal changes, primarily mediated by elevated prolactin levels, which suppress ovulation and result in progesterone levels comparable to those observed during the follicular phase of the menstrual cycle. Although progesterone levels increase following conception, the hormonal milieu during lactation may influence progesterone production and regulation in early pregnancy. However, normal reference ranges for serum progesterone levels in lactating pregnant women have not been clearly established, and data regarding their association with threatened abortion remain limited.

In this study, pregnant women who conceive during the lactation period will be enrolled. Maternal serum progesterone levels will be measured during the first trimester, and participants will be evaluated for the presence or absence of threatened abortion, defined as first-trimester vaginal bleeding with a viable intrauterine pregnancy. Clinical, obstetric, and demographic data will be recorded to allow assessment of potential confounding factors.

By examining the relationship between serum progesterone levels and threatened abortion in lactating pregnancies, this study aims to provide new insights into the hormonal mechanisms underlying early pregnancy complications. The findings may contribute to improved risk stratification, early diagnosis, and management strategies for threatened abortion in this specific population. Additionally, the study seeks to expand the limited body of literature on lactation-associated hormonal changes during early pregnancy and their clinical implications.

Inclusion criteria

• Female participants aged 18 to 50 years.
• Pregnant women who conceived during the lactation period.
• Singleton pregnancy.
• First-trimester pregnancy.
• Availability of first-trimester serum progesterone measurement obtained as part of routine antenatal care.
• Ongoing follow-up at the participating hospitals.

Exclusion criteria

• Age under 18 years or over 50 years.
• Multiple pregnancies.
• Known chronic medical diseases.
• Use of progesterone supplementation before serum progesterone measurement.
• Missing or incomplete clinical or laboratory data.