Dodd Jodie M, Crowther Caroline A, Cincotta Robert, Flenady Vicki, Robinson Jeffrey S
Department of Obstetrics and Gynaecology, The University of Adelaide, Australia.
Acta Obstet Gynecol Scand. 2005 Jun;84(6):526-33. doi: 10.1111/j.0001-6349.2005.00835.x.
The aim of this study is to assess the role of progesterone in preterm birth prevention.
A MEDLINE search (from 1966 to the present; date of last search January 2005) was performed - using the key words progesterone, pregnancy, preterm birth, preterm labor, and randomized, controlled trial - in order to identify randomized, controlled trials in which progesterone (either intramuscular or vaginal administration) was compared with placebo or no treatment. Data were extracted and a meta-analysis was performed.
Seven randomized, controlled trials were identified. Women who received progesterone were statistically significantly less likely to give birth before 37 weeks (seven studies, 1020 women, RR = 0.58, 95% CI = 0.48-0.70), to have an infant with birth weight of < or =2.5 kg (six studies, 872 infants, RR = 0.62, 95% CI = 0.49-0.78), or to have an infant diagnosed with intraventricular hemorrhage (one study, 458 infants, RR = 0.25, 95% CI = 0.08-0.82).
For progesterone supplementation to be advocated for women at the risk of preterm birth, the prolongation of gestation demonstrated in this meta-analysis must translate into improved infant outcomes, including a reduction in mortality. There is currently insufficient information to allow recommendations regarding the optimal dose, route, and timing of administration of progesterone supplementation.
本研究旨在评估孕酮在预防早产中的作用。
进行了一次MEDLINE检索（从1966年至当前；最后检索日期为2005年1月），使用关键词“孕酮”“妊娠”“早产”“早产临产”以及“随机对照试验”，以识别将孕酮（肌肉注射或阴道给药）与安慰剂或不治疗进行比较的随机对照试验。提取数据并进行荟萃分析。
识别出七项随机对照试验。接受孕酮治疗的女性在37周前分娩的可能性在统计学上显著降低（七项研究，1020名女性，RR = 0.58，95%CI = 0.48 - 0.70），产下出生体重≤2.5 kg婴儿的可能性降低（六项研究，872名婴儿，RR = 0.62，95%CI = 0.49 - 0.78），或产下被诊断为脑室内出血婴儿的可能性降低（一项研究，458名婴儿，RR = 0.25，95%CI = 0.08 - 0.82）。
为了倡导对有早产风险的女性补充孕酮，本荟萃分析中显示的孕周延长必须转化为改善婴儿结局，包括降低死亡率。目前尚无足够信息就孕酮补充的最佳剂量、途径和给药时间提出建议。
