Obstet Gynecol:产后立即接受长效醋酸甲羟孕酮的女性静脉血栓栓塞风险

2019-02-19 xing.T 网络

由此可见,产后立即接受DMPA与低发病率相关,但与不使用激素避孕相比,VTE的相对风险增加。

近日,妇产科权威杂志Obstetrics and Gynecology上发表了一研究文章,研究人员旨在评估产后立即开始长效醋酸甲羟孕酮(DMPA)的妇女与不开始激素避孕的妇女的静脉血栓栓塞(VTE)的绝对和相对风险。

研究人员采用IBM MarketScan商业索赔和Encounters数据库确定2005年至2014年期间15-44岁的分娩住院女性。诊断、手术操作和药物代码用于识别避孕、VTE和潜在的混淆慢性或妊娠-相关疾病。在产后第0天至第7天启动DMPA的女性与产后0至7天未启动激素避孕的女性进行比较。从分娩到产后12周,女性随访VTE事件的发生,在激素避孕开始或处方、子宫切除术、绝育或住院死亡时进行检查。研究人员计算了各组VTE发生率和95%CI,并比较两组的发病率比。

产后12周未调整的VTE发病率在产后即刻接受DMPA组为0.42/10000名女性每日(11159个女性中有34次事件,80-9999天随访),对照组为0.15/10000名女性每日( 3102011名妇女中有3107次事件,其随访为206180811天)。仅针对年龄进行调整产后,与对照组女性相比,即刻接受DMPA组女性VTE发生率为2.87(95%CI为2.05-4.03)。调整年龄和妊娠相关和慢性病后,与对照组女性相比,产后即刻接受DMPA组女性的VTE调整发生率为1.94(95%CI1.38-2.72)。

由此可见,产后立即接受DMPA与低发病率相关,但与不使用激素避孕相比,VTE的相对风险增加。

原始出处:
 
Tepper, Naomi K, et al.Venous Thromboembolism Among Women Initiating Depot Medroxyprogesterone Acetate Immediately Postpartum.Obstetrics & Gynecology.2019.https://journals.lww.com/greenjournal/Abstract/publishahead/Venous_Thromboembolism_Among_Women_Initiating.97808.aspx
 
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    2019-03-29 yhy100200
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    2019-03-21 xue8602
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    2019-12-16 fusion
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