Wong Jeffrey Man Hay, Kanga Neha, Dogra Nupur, Ngoma Mary Shilalukey, Serghides Lena, Silverman Michael
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Pediatrics, University of Zambia, Lusaka, Zambia.
Int J Womens Health. 2017 Nov 16;9:827-833. doi: 10.2147/IJWH.S136191. eCollection 2017.
Intramuscular and vaginal progesterone are recommended for prevention of preterm labor (PTL) in women with risk factors. Studies are emerging to indicate that HIV-infected women on combination antiretroviral therapy (cART) are at risk of PTL and low birth weight (LBW), and may benefit from supplemental progesterone. This study aims to determine the perceived acceptability of various modes of progesterone supplementation to prevent PTL and LBW in HIV-infected and HIV-uninfected women.
HIV-infected and HIV-uninfected women were recruited in Lusaka, Zambia. The participants completed a questionnaire to assess their willingness to take oral, vaginal, or intramuscular progesterone supplementation for preventing PTL and LBW, preferred modes of supplementation, and concern for PTL and LBW.
The study questionnaire was completed by 147 participants. Of the participants, 98.6% would consider using a medication to help prevent PTL and LBW, of whom 97.9% would consider using an oral form of progesterone. In addition, 83.3% and 84.0% of women would consider intramuscular and vaginal (gel or tablet) administration of progesterone respectively. Between intramuscular and vaginal modes of progesterone, 60.5% of participants (n=147) preferred intramuscular progesterone, while 39.5% preferred vaginal progesterone. There was no difference in preference between HIV-infected (n=70) and HIV-uninfected (n=77) women.
CONCLUSIONS/IMPLICATIONS: Pregnant Zambian women demonstrated a high degree of acceptance for all modes of progesterone supplementation for the prevention of PTL and LBW. Women preferred intramuscular over vaginal supplementation. Progesterone supplementation can be considered a feasible intervention for preventing PTL and LBW in both HIV-infected and HIV-uninfected pregnant Zambian women.
对于有风险因素的女性，推荐使用肌肉注射和阴道用黄体酮预防早产（PTL）。越来越多的研究表明，接受联合抗逆转录病毒疗法（cART）的HIV感染女性有早产和低出生体重（LBW）的风险，补充黄体酮可能有益。本研究旨在确定各种黄体酮补充方式在预防HIV感染和未感染女性的早产及低出生体重方面的可接受性。
在赞比亚卢萨卡招募HIV感染和未感染的女性。参与者完成一份问卷，以评估她们对口服、阴道或肌肉注射黄体酮预防早产和低出生体重的意愿、首选的补充方式以及对早产和低出生体重的担忧。
147名参与者完成了研究问卷。其中，98.6%的人会考虑使用药物帮助预防早产和低出生体重，其中97.9%的人会考虑使用口服黄体酮。此外，分别有83.3%和84.0%的女性会考虑肌肉注射和阴道（凝胶或片剂）使用黄体酮。在肌肉注射和阴道使用黄体酮两种方式之间，60.5%的参与者（n = 147）更喜欢肌肉注射黄体酮，而39.5%的人更喜欢阴道用黄体酮。HIV感染女性（n = 70）和未感染女性（n = 77）之间在偏好上没有差异。
结论/启示：赞比亚孕妇对所有预防早产和低出生体重的黄体酮补充方式接受度都很高。女性更喜欢肌肉注射而非阴道补充。对于预防赞比亚感染和未感染HIV的孕妇的早产和低出生体重，补充黄体酮可被视为一种可行的干预措施。
