固体器官移植妇女的避孕安全性和有效性:更新的系统性审查
Courtney C Baker1, Tanvi Suresh2, Antoinette T Nguyen2
1Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA; Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Contraception
|September 10, 2025
概括
基于有限的证据,对于实体器官移植的妇女来说,诸如levonorgestrel宫内器械 (LNG-IUD) 和荷尔蒙方法等避孕药似乎是安全有效的. 建议进行进一步的研究来证实这些发现并解决潜在的风险.
科学领域:
- 生殖健康 生殖健康
- 移植医学 移植医学 移植医学
- 药物监督 药物监督 药物监督
背景情况:
- 经过实体器官移植的妇女需要安全有效的避孕措施.
- 更新了此前关于避孕药在该人群中的安全性和有效性的审查.
- 评估避孕选择对于移植受体的生殖健康管理至关重要.
研究的目的:
- 系统地审查和更新关于女性固体器官移植避孕方法安全性和有效性的证据.
- 综合最近研究的发现,为临床实践和患者咨询提供信息.
- 为了识别在这个特定的患者群体中关于避孕药的知识差距.
主要方法:
- 系统地搜索多个数据库,直到2022年12月为任何设计的研究.
- 纳入研究检查避孕安全性和有效性在女性有固体器官移植.
- 数据提取,偏差风险评估,以及包含文章的证据确定性的确定性.
主要成果:
- 包括26篇文章 (11个队列研究,15个案例系列/报告),大多数队列研究具有中度至高偏差风险.
- 在非比较性研究 (n=55) 中,Levonorgestrel宫内器械 (LNG-IUD) 没有显示出怀孕或盆腔感染,在比较性研究 (n=16) 中,效果相似.
- 与对照组或不使用避孕药相比,非宫内节育器的激素避孕药,包括乙凝植入物和口服避孕药,没有显著的不良安全结果或增加怀孕率.
结论:
- 非常低的确定性证据表明,LNG-IUD和非IUD激素避孕药与女性固体器官移植的不良安全性或有效性结果无关.
- 这些证据可以帮助医疗保健提供者和患者在咨询和关于避孕的共同决策方面提供帮助.
- 需要进一步的研究来调查与移植受体使用荷尔蒙避孕药相关的潜在风险,如血栓形成和心血管事件.
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