环形后的孕激素补充剂没有改善早产率
Lauren C Sayres1, Natalie T Simon1, Virginia Lijewski2
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, United States.
American journal of perinatology
|May 12, 2025
概括
在 cerclage 后的辅助孕激素不会降低早产率,并且可能缩短到分娩的时间. 这项研究发现,孕补充后的孕补充对母亲或新生儿没有益处.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 宫衰竭是早产的主要原因之一.
- 带安置是一种常见的干预措施,以防止早产.
- 在 cerclage 之后辅助孕激素的作用仍然存在争议.
研究的目的:
- 评估辅助性孕激素在通过阴道结合后减少早产率方面的疗效.
- 评估孕激素补充剂对母亲和新生儿结局的影响.
- 分析孕激素配方和 cerclage 指示对结果的影响.
主要方法:
- 451名接受过阴道穿器的患者 (2005-2021) 的回顾性队列审查.
- 在有或没有辅助孕激素的患者之间比较早产率 (<37周).
- 进行了多变量回归,子组和倾向得分匹配分析.
主要成果:
- 辅助孕激素与早产率的增加有关 (45%对34%,p=0.03).
- 在使用孕激素时,从宫到分娩的中位延迟时间较短 (119 vs. 139天,p<0.001).
- 没有观察到二次母亲或新生儿结局的显著差异.
结论:
- 在 cerclage 之后的辅助孕激素不会降低早产率,并且可能与危害相关.
- 目前的数据不支持 cerclage 和 postcerclage 孕激素的协同效益.
- 需要进行进一步的研究,以制定关于在 cerclage 后使用孕激素的指南.
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