孕激素預防早產的研究進展

Update of progestogen in prevention of preterm birth

孕激素用於預防早產已經有50年歷史,但是對與它的療效及適用人群仍有爭論,本文就其對母胎影響及副作用進行綜述。研究表明,孕激素對用於曾有自發性早產的單胎妊娠者的證據可靠度為中度,用於宮頸縮短的單胎妊娠者的證據可靠度為低度。對於多胎妊娠者無效的證據可靠度為中度。對於其他情況下使用的證據不足。孕激素預防新生兒患病率及死亡率還有待進一步研究。

Progestogen administration has been investigated to prevent preterm births for more than 50 years,but the efficacy and indication are controversial.We undertook this review to systematically update what was known about use of progestogens for prevention of preterm birth.Progestogens prevent preterm birth when used in singleton pregnancy in which the mother has had a prior spontaneous preterm birth or in which cervical length is short.The strength of the evidence supporting its use for these indications is moderate and low,respectively.In contrast,moderate strength of evidence suggests lack of effectiveness for multiple gestations.Evidence is insufficient for all other uses.Across indications,data are sparse to evaluate influence on near-term outcomes such as neonatal mortality and morbidities.Evidence is insufficient for understanding whether intervention has the ultimately desired outcome of preventing morbidity and promoting normal childhood development.