孕激素用于预防未明原因的反复流产的妇女流产
David M Haas1, Magdalena Bofill Rodriguez2, Taylor J Hathaway1
1Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
反复流产的孕激素补充剂可能对流产率或活产率几乎没有影响. 这种疗法可能对经历重复流产的妇女没有好处.
科学领域:
- 生殖医学和内分泌学.
- 产科和妇科 产科和妇科
- 临床试验分析
背景情况:
- 孕激素对于子宫的接受性和成功的植入至关重要.
- 经常性流产可能与不充分的孕激素分泌有关.
- 孕激素用于预防流产,但其有效性仍有争议.
研究的目的:
- 评估孕激素治疗的益处和危害,以预防复发性流产.
- 评估孕激素对流产,活产和早产率的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 纳入标准:怀孕的参与者有反复流产,在妊娠的第一季度接受了孕激素治疗.
- 搜索了多个数据库;使用GRADE评估了偏差风险和证据确定性.
主要成果:
- 纳入了9项试验,共有1276名参与者;大多数具有偏差风险较低.
- 与安慰剂相比,孕激素补充剂在流产率 (RR 0.91) 中几乎没有差异.
- 生产率也相似 (RR 1.04);关于早产的证据的确定性非常低.
结论:
- 孕激素补充剂可能对无法解释的反复流产的妇女的结果几乎没有影响.
- 目前的证据表明,在这个人群中,使用孕激素预防流产没有明显的益处.
- 需要进一步的研究来澄清对特定子组和不良事件的影响.
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