NEJM:孕酮不能提高复发性流产女性的活产婴儿率

2015-11-26 崔倩 译 MedSci原创

孕酮是维持妊娠的关键。然而,无论是在怀孕的头三个月补充孕激素会增加与不明原因反复流产史妇女的出生率是不确定的。

黄体酮是用于维持妊娠所必需的。然而,在怀孕的前三个月补充黄体酮是否会增加不明原因的反复流产史孕妇的活产婴儿率,是不确定的。

研究人员进行了一项多中心、双盲、安慰剂对照、随机试验,探讨了孕激素治疗是否会增加具有不明原因的反复流产史女性的活产婴儿和新生儿生存率。研究人员随机分配在妊娠12周内(不迟于6周)的习惯性流产女性接受400mg微粉化孕酮或相应安慰剂,纳阴道,每天两次。主要成果是妊娠24周后活产情况。

总共有1568名女性被评定为合格,其中836名女性在1年内自然受孕,并自愿参加试验,她们被随机分配接受孕酮(404名女性)或安慰剂(432名女性)。主要成果的随访率为98.8%(836名女性中的826名)。在意向性治疗分析中,活产率分别为孕酮组65.8%(398名女性中的262名),安慰剂组为63.3%(428名女性中的271名)(相对比率,1.04;95%置信区间[Cl],0.94至1.15;比率的差异,2.5个百分点;95%Cl,-4.0至9.0)。不良事件的发生率没有显著组间差异。

在怀孕的前三个月孕激素治疗没有导致有不明原因的反复流产史的女性有显著提高的活产婴儿率。

原始出处:

Arri Coomarasamy,Helen Williams,Ewa Truchanowicz,et al.A Randomized Trial of Progesterone in Women with Recurrent Miscarriages,NEJM,2015.11.26

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1634408, encodeId=1ad61634408c2, content=<a href='/topic/show?id=3e8842545ee' target=_blank style='color:#2F92EE;'>#复发性流产#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42545, encryptionId=3e8842545ee, topicName=复发性流产)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab8122165335, createdName=spoonycyy, createdTime=Fri Oct 07 17:35:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909587, encodeId=a387190958e9a, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sun Oct 16 06:35:00 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45760, encodeId=5a9145e60fe, content=值得探讨咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45761, encodeId=675845e61a3, content=为什么一篇15的文章会有12年平均记录~, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471026, encodeId=567714e10263b, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Fri Nov 27 23:35:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1634408, encodeId=1ad61634408c2, content=<a href='/topic/show?id=3e8842545ee' target=_blank style='color:#2F92EE;'>#复发性流产#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42545, encryptionId=3e8842545ee, topicName=复发性流产)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab8122165335, createdName=spoonycyy, createdTime=Fri Oct 07 17:35:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909587, encodeId=a387190958e9a, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sun Oct 16 06:35:00 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45760, encodeId=5a9145e60fe, content=值得探讨咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45761, encodeId=675845e61a3, content=为什么一篇15的文章会有12年平均记录~, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471026, encodeId=567714e10263b, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Fri Nov 27 23:35:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1634408, encodeId=1ad61634408c2, content=<a href='/topic/show?id=3e8842545ee' target=_blank style='color:#2F92EE;'>#复发性流产#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42545, encryptionId=3e8842545ee, topicName=复发性流产)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab8122165335, createdName=spoonycyy, createdTime=Fri Oct 07 17:35:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909587, encodeId=a387190958e9a, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sun Oct 16 06:35:00 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45760, encodeId=5a9145e60fe, content=值得探讨咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45761, encodeId=675845e61a3, content=为什么一篇15的文章会有12年平均记录~, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471026, encodeId=567714e10263b, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Fri Nov 27 23:35:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2015-12-13 cmn

    值得探讨咯

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1634408, encodeId=1ad61634408c2, content=<a href='/topic/show?id=3e8842545ee' target=_blank style='color:#2F92EE;'>#复发性流产#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42545, encryptionId=3e8842545ee, topicName=复发性流产)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab8122165335, createdName=spoonycyy, createdTime=Fri Oct 07 17:35:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909587, encodeId=a387190958e9a, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sun Oct 16 06:35:00 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45760, encodeId=5a9145e60fe, content=值得探讨咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45761, encodeId=675845e61a3, content=为什么一篇15的文章会有12年平均记录~, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471026, encodeId=567714e10263b, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Fri Nov 27 23:35:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2015-12-13 cmn

    为什么一篇15的文章会有12年平均记录~

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1634408, encodeId=1ad61634408c2, content=<a href='/topic/show?id=3e8842545ee' target=_blank style='color:#2F92EE;'>#复发性流产#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42545, encryptionId=3e8842545ee, topicName=复发性流产)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab8122165335, createdName=spoonycyy, createdTime=Fri Oct 07 17:35:00 CST 2016, time=2016-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909587, encodeId=a387190958e9a, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sun Oct 16 06:35:00 CST 2016, time=2016-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45760, encodeId=5a9145e60fe, content=值得探讨咯, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=45761, encodeId=675845e61a3, content=为什么一篇15的文章会有12年平均记录~, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sun Dec 13 11:17:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471026, encodeId=567714e10263b, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Fri Nov 27 23:35:00 CST 2015, time=2015-11-27, status=1, ipAttribution=)]
    2015-11-27 周虎

相关资讯

Clin Endocrinol:孕酮或可导致游离T4水平增加

甲状腺激素和孕酮都影响体温、代谢,并且在妊娠期间非常重要。为了探讨与安慰剂相比,孕酮治疗是否能导致甲状腺生理改变,来自不列颠哥伦比亚大学J C Prior教授及其团队进行了一项研究,该研究发现黄体酮或者导致游离T4显著增加。该研究结果发表在2013年8月Clinical Endocrinology杂志上。【原文下载】 该研究对一个学术医疗中心进行的一项12周口服微粒化黄体酮(黄体酮,睡

Contraception:避孕器LNG20的有效性和安全性

Eisenberg DL等人纳入了16-45岁具有正常月经周期和要求避孕的未生育过的和生育过的女性,对其进行了一项非盲、部分随机试验,通过3年数据评估新的设计为可以使用7年以上的52mg左炔诺孕酮宫内节育器(LNG20)的有效性和安全性。初始结局指标为16-35岁女性按珀尔指数计算的妊娠率和有效性。其中36-45岁女性纳入该研究仅仅是针对LNG20的安全性的研究。研究期间研究人员对所有参与者大约每

NEJM:了解肿瘤背后的祸首

子宫肌瘤是最常见的一种女性肿瘤,近年来在了解这类肿瘤的起始和生长机制方面取得了巨大的进展。发表在10月3日《新英格兰医学》(NEJM)杂志上的一篇新论文,综述了有关孕酮、干细胞和肿瘤突变在子宫肌瘤中所起作用的最新研究进展,为研究和药物开发指出了新方向。 论文的作者、美国西北大学Feinberg医学院及西北纪念医院妇产科学教授Serdar Bulun博士说:“这些研究发现代表了我们探讨新治疗的思维

Am J Obstet Gynecol:阴道黄体酮安胎效果怎么样?

目的:我们试图评价阴道孕酮维持与对照组(安慰剂或无治疗),比较两组的安胎功效,对单胎终止妊娠早产(PTL)进行荟萃分析与随机对照试验。实验设计:检索MEDLINE、OVID、 Scopus、ClinicalTrials.gov、和Cochrane对照试验注册中心的数据库,随着使用不同的关键词和文本:“黄体酮”、“安胎”、和“早产”,检索从1966年到2014年11月的文献。本研究随机搜集了单胎终止

细数孕酮那些事

妊娠时,hCG刺激黄体产生孕酮;7~9周逐渐过渡致胎盘产生,又称黄体胎盘转移;10~11周胎盘产生孕酮明显增加,这时胎盘的滋养细胞接替黄体产生孕激素并维持妊娠。孕期孕酮检查主要用于了解黄体的功能及卵巢有无排卵以及了解妊娠状态等。 孕酮的作用是什么 成年未怀孕妇女的孕酮主要作用是与雌激素配合,参与维持正常月经周期的功能活动;妊娠期间孕酮主要由胎盘产生,其含量随孕周而增加。孕酮在雌