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本文引用的文献

1
Births: final data for 2013.出生情况：2013年最终数据。
Natl Vital Stat Rep. 2015 Jan 15;64(1):1-65.
2
Maintenance tocolysis with oral micronized progesterone for prevention of preterm birth after arrested preterm labor.口服微粒化孕酮维持tocolysis预防早产宫缩停止后早产
Int J Gynaecol Obstet. 2014 Jul;126(1):60-3. doi: 10.1016/j.ijgo.2014.01.019. Epub 2014 Apr 3.
3
The Effects of Progesterone Therapy on the Gestation Length and Reduction of Neonatal Complications in Patients who had Received Tocolytic Therapy for Acute Phase of Preterm Labor.孕酮治疗对接受宫缩抑制剂治疗早产急性期患者妊娠时长及新生儿并发症减少的影响。
Iran Red Crescent Med J. 2013 Oct;15(10):e7947. doi: 10.5812/ircmj.7947. Epub 2013 Oct 5.
4
Progestational agents for treating threatened or established preterm labour.用于治疗先兆早产或已确诊早产的孕激素制剂。
Cochrane Database Syst Rev. 2014 Jan 31;2014(1):CD006770. doi: 10.1002/14651858.CD006770.pub3.
5
17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30 mm.17α-羟孕酮己酸酯预防宫颈长度小于 30mm 的初产妇早产。
Am J Obstet Gynecol. 2012 Nov;207(5):390.e1-8. doi: 10.1016/j.ajog.2012.09.013. Epub 2012 Sep 17.
6
Prevention of preterm delivery after successful tocolysis in preterm labor by 17 alpha-hydroxyprogesterone caproate: a randomized controlled trial.17α-羟孕酮己酸酯预防早产临产成功保胎后的早产：一项随机对照试验。
Am J Obstet Gynecol. 2012 Mar;206(3):206.e1-9. doi: 10.1016/j.ajog.2011.12.026. Epub 2011 Dec 27.
7
Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial.阴道用孕酮降低超声检查宫颈短的孕妇早产率：一项多中心、随机、双盲、安慰剂对照试验。
Ultrasound Obstet Gynecol. 2011 Jul;38(1):18-31. doi: 10.1002/uog.9017. Epub 2011 Jun 15.
8
miR-200 family and targets, ZEB1 and ZEB2, modulate uterine quiescence and contractility during pregnancy and labor.miR-200 家族及其靶基因 ZEB1 和 ZEB2 调节妊娠和分娩期间子宫的静止和收缩性。
Proc Natl Acad Sci U S A. 2010 Nov 30;107(48):20828-33. doi: 10.1073/pnas.1008301107. Epub 2010 Nov 15.
9
The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.《系统评价与Meta分析优先报告条目声明》：针对评估卫生保健干预措施的研究的报告规范解释与阐述
Ann Intern Med. 2009 Aug 18;151(4):W65-94. doi: 10.7326/0003-4819-151-4-200908180-00136. Epub 2009 Jul 20.
10
Effect of progesterone on proinflammatory cytokine production by monocytes stimulated with pathogens associated with preterm birth.孕酮对与早产相关病原体刺激的单核细胞产生促炎细胞因子的影响。
Am J Reprod Immunol. 2008 Oct;60(4):346-53. doi: 10.1111/j.1600-0897.2008.00633.x.

对胎膜完整的早产女性使用孕激素进行维持性保胎治疗的系统评价和荟萃分析。

A systematic review and meta-analysis of progestogen use for maintenance tocolysis after preterm labor in women with intact membranes.

作者信息

Eke Ahizechukwu C, Chalaan Tina, Shukr Ghadear, Eleje George U, Okafor Charles I

机构信息

Department of Obstetrics and Gynecology, Michigan State University/Sparrow Hospital, Lansing, MI, USA.

College of Human Medicine, Michigan State University, Lansing, MI, USA.

出版信息

Int J Gynaecol Obstet. 2016 Jan;132(1):11-6. doi: 10.1016/j.ijgo.2015.06.058. Epub 2015 Oct 18.

DOI:10.1016/j.ijgo.2015.06.058
PMID:26489489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9941008/
Abstract

BACKGROUND

The use of progestogens for maintenance tocolysis remains controversial, with randomized controlled trials having conflicting results on their efficacy.

OBJECTIVES

To evaluate the use of progestational agents for maintenance tocolysis after preterm labor in a systematic review of randomized controlled trials.

SEARCH STRATEGY

Electronic databases were searched for reports published before December 2014. Keywords included "tocolysis," "progesterone," "preterm labor," "17-alpha-hydroxyprogesterone," and "vaginal progesterone."

SELECTION CRITERIA

Only randomized controlled trials involving progestational agents for maintenance tocolysis were included.

DATA COLLECTION AND ANALYSIS

Outcomes were analyzed on an intent-to-treat basis and meta-analysis was performed where appropriate. Relative risks and mean differences with 95% confidence intervals were calculated.

MAIN RESULTS

Four studies (362 women) were included. There were no significant differences between progestational agents and placebo/no treatment in terms of delivery before 34weeks or before 37weeks of pregnancy, time from randomization to delivery, and respiratory distress syndrome. Progestogens were associated with an increase in the neonatal birth weight (mean difference 203.32g, 95% confidence interval 110.85-295.80; P=0.032).

CONCLUSIONS

The current evidence does not support the routine use of progestational agents for maintenance tocolysis after an episode of preterm labor.

摘要

背景

使用孕激素进行维持性保胎治疗仍存在争议，随机对照试验对其疗效的结果相互矛盾。

目的

在一项随机对照试验的系统评价中，评估孕激素制剂在早产后宫缩抑制维持治疗中的应用。

检索策略

检索电子数据库中2014年12月之前发表的报告。关键词包括“宫缩抑制”“孕酮”“早产”“17-α-羟孕酮”和“阴道用孕酮”。

选择标准

仅纳入涉及孕激素制剂用于维持性宫缩抑制的随机对照试验。

数据收集与分析

按意向性分析原则分析结果，并在适当情况下进行荟萃分析。计算相对风险和95%置信区间的均值差。

主要结果

纳入4项研究（362名女性）。在妊娠34周前或37周前分娩、随机分组至分娩的时间以及呼吸窘迫综合征方面，孕激素制剂与安慰剂/未治疗之间无显著差异。孕激素与新生儿出生体重增加相关（均值差203.32g，95%置信区间110.85 - 295.80；P = 0.032）。

结论

目前的证据不支持在早产发作后常规使用孕激素制剂进行维持性宫缩抑制治疗。