孕激素在遭受流产威胁或反复流产的妇女身上:一个元分析
Yunli Zhao1,2,3, Rohan D'Souza4,5, Ya Gao4,6
1Department of Geriatric Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Acta obstetricia et gynecologica Scandinavica
|March 14, 2024
概括
孕激素补充剂可能会增加患有流产风险的妇女的活产,但不对不良事件有显著的增加. 这种益处可能在有流产史的女性中最为明显.
科学领域:
- 生殖医学 生殖医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 临床实践指导方针对孕激素用于威胁和重复流产的使用提供了相互矛盾的建议.
- 进行了系统性审查和元分析,以评估孕激素的有效性和安全性.
研究的目的:
- 评估孕激素补充剂在有威胁或复发性流产的孕妇中的疗效和安全性.
- 综合随机对照试验 (RCT) 的证据,以告知临床实践.
主要方法:
- 在Medline,Embase和Cochrane Central进行了全面的文献搜索,直到2023年10月.
- 包括RCT比较孕激素补充剂与安慰剂或没有治疗.
- 偏差风险和证据确定性分别使用修改后的Cochrane和GRADE方法进行评估.
主要成果:
- 孕激素可能会增加威胁流产的活产 (中度确定性).
- 有证据表明,孕激素可能会增加有两个或两个以上流产史的妇女的活产 (中等确定性).
- 孕激素对先天性异常或其他严重的不良妊娠事件几乎没有影响 (中等确定性).
结论:
- 孕激素可能会提高孕产妇流产风险较高的妇女的活产率.
- 随着孕激素的使用,孕产妇和新生儿的不良事件并没有显著增加.
- 孕激素的好处可能对有先前流产史的人来说更为重要.
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