Zipori Yaniv, Lauterbach Roy, Matanes Emad, Beloosesky Ron, Weiner Zeev, Weissman Amir
Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel.
Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel.
Eur J Obstet Gynecol Reprod Biol. 2018 Nov;230:6-9. doi: 10.1016/j.ejogrb.2018.09.011. Epub 2018 Sep 11.
We aimed to determine whether daily vaginal progesterone use for the prevention of preterm birth has an effect on the incidence of abnormal glucose challenge test or gestational diabetes.
A retrospective study in a large referral center. Women with cervical length ≤ 25 mm were given 200 mg vaginal micronized progesterone capsules daily at bed time until 36 weeks` gestation or delivery. Each progesterone-treated woman was matched randomly with three untreated controls. The main outcome measures were; mean plasma glucose level following the glucose challenge test and the rate of abnormal 1-hour glucose challenge test. Secondary outcome was the rate of gestational diabetes.
We identified 108 progesterone-treated women that were matched by age and BMI to 324 controls during the same time period. The mean plasma glucose level following the glucose challenge test was similar in both groups (115.3 ± 33.8 mg/dL versus 109.2 ± 26.6 mg/dL). Despite a higher rate of an abnormal glucose challenge test in the progesterone-treated group compared to the control group (21.1% vs. 13.9%), it did not reach statistical significance. Similarly, we could not detect any difference in the rate of gestational diabetes in either the study or the control group (2.8% versus 2.5%).
Daily vaginal progesterone was not associated with higher rates of abnormal glucose challenge test or gestational diabetes. We are in a view that no earlier screening or diagnostic testing for gestational diabetes is required except the standard recommended schedule unless additional risk factors are present.
我们旨在确定每日阴道使用孕酮预防早产是否会对葡萄糖耐量试验异常或妊娠期糖尿病的发生率产生影响。
在一个大型转诊中心进行的回顾性研究。宫颈长度≤25mm的女性在睡前每日服用200mg阴道微粒化孕酮胶囊，直至妊娠36周或分娩。每位接受孕酮治疗的女性随机与三名未治疗的对照者匹配。主要观察指标为：葡萄糖耐量试验后的平均血糖水平和1小时葡萄糖耐量试验异常率。次要观察指标为妊娠期糖尿病发生率。
我们确定了108名接受孕酮治疗的女性，她们在年龄和体重指数方面与同期的324名对照者匹配。两组葡萄糖耐量试验后的平均血糖水平相似（115.3±33.8mg/dL对109.2±26.6mg/dL）。尽管孕酮治疗组的葡萄糖耐量试验异常率高于对照组（21.1%对13.9%），但未达到统计学显著性。同样，我们在研究组或对照组中均未检测到妊娠期糖尿病发生率的差异（2.8%对2.5%）。
每日阴道使用孕酮与葡萄糖耐量试验异常或妊娠期糖尿病的较高发生率无关。我们认为，除非存在其他危险因素，否则除标准推荐的时间表外，无需对妊娠期糖尿病进行更早的筛查或诊断检测。
