孕激素在自发性早产防治中的研究进展

Research Progress on Progestins Treatment for the Prevention of Spontaneous Preterm Birth

在中国,妊娠满28周至不足37周间分娩称为早产,分为自发性早产和治疗性早产两种。早产是导致新生儿致病及死亡的主要原因,即使存活亦常有神经智力发育缺陷。目前动物实验、体外实验及大样本随机对照试验证明,孕激素治疗(包括孕酮及人工合成孕激素)能减少早产风险。孕酮通过维持子宫静止状态和抑制宫颈成熟预防早产,维持妊娠。综述孕激素在自发性早产高危患者中的防治作用及其使用安全性。

Preterm birth is defined as birth between 28 and 37 completed weeks of gestation in China,and classified as either indicated preterm birth or spontaneous preterm birth.Preterm birth causes the major determinant of perinatal mortality and morbidity,and the long-term results of preterm birth often lead to neural and mental developmental defects.There is experimental support from animal and in vitro studies,and also empirical evidence from large randomized placebo-controlled clinical trials,that treatment with progestins（includes natural progesterone and its analogues） may reduce the risk of preterm birth.Progesterone has a role in maintaining pregnancy,by maintaining uterine quiescence and inhibiting cervical riping.This article reviews the use of progestins in women with high-risk factors for the prevention of spontaneous preterm birth and the safety of progestins supplementation in pregnancy.