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Effect of dydrogesterone and progesterone on threatened miscarriage due to corpus luteum insufficiency
Caiyu Lou1, Caiwen Wang2, Qiang Zhao3
1Department of Obstetrics and Gynecology, The Sixth People's Hospital of Zhuji Zhuji, Zhejiang Province, China.
Objective:
To investigate the efficacy and safety of dydrogesterone and progesterone in the treatment of threatened miscarriage due to corpus luteum insufficiency.
Methods:
A prospective cohort study was designed and a total of 1,285 patients with threatened miscarriage due to corpus luteum insufficiency were recruited, in which 665 participants received dydrogesterone treatment (dydrogesterone group), and the other 620 received progesterone treatment (progesterone group). The time for clinical symptom relief, changes of sex hormone levels in serum, the rate of miscarriage prevention, delivery outcome, and adverse effects were compared between the two groups. XGBoost algorithm was applied to analyze the factors impacting the efficacy and safety of each treatment.
Results:
There was no significant difference regarding the time for clinical symptom relief and the rate of miscarriage prevention between the two groups (P>0.05, RR=1.01, 95% CI: 0.97-1.06, P=0.566). However, after 4 weeks of treatment, compared with the progesterone group, the level of sex hormones was significantly upregulated, while the preterm birth rate (9.65% vs. 14.04%), the postpartum hemorrhage rate (3.10% vs. 5.62%), and the incidence of adverse effects (17.44% vs. 32.58%) were considerably reduced in the dydrogesterone group (all P<0.05). XGBoost algorithm analysis demonstrated that dydrogesterone treatment was correlated with a lower incidence of preterm birth rate, postpartum hemorrhage, and adverse effects, ranking the 3rd, 2nd and 1st, respectively, in the weight of dependent variables.
Conclusion:
Compared with progesterone, dydrogesterone can improve the delivery outcome and demonstrate a higher safety in the treatment of threatened miscarriage due to corpus luteum insufficiency.
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