Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Wuhan, China.
BMC Pregnancy Childbirth. 2022 May 5;22(1):390. doi: 10.1186/s12884-022-04711-1.
Progesterone is widely used to improve the adverse pregnancy outcomes related to vaginal bleeding during early pregnancy. However, the evidence of its effectiveness is equivocal.
Six thousand six hundred fifteen mother-infant pairs from Tongji Maternal and Child Health Cohort (TMCHC) were involved in the study. Information on vaginal bleeding, progesterone administration in early pregnancy were obtained at enrolment. Birth outcomes were obtained from the hospital notes. Body weight of the infants at 12 months of age was collected by telephone interview. Multivariable logistic regression was conducted to estimate the effect of vaginal bleeding and progesterone administration in early pregnancy on birth outcomes and weight status of infants at 12 months of age.
21.4% (1418/6615) participants experienced bleeding in early pregnancy, and 47.5% (674/1418) of them were treated with progesterone. There were no significant associations between progesterone supplementation in early pregnancy and offspring outcomes. Compared to women without bleeding or any therapy, women with bleeding and progesterone therapy experienced increased risk of preterm (OR 1.74, 95% CI 1.21-2.52), and delivering a small-for-gestational-age (SGA) (OR 1.46, 95% CI 1.07-1.98) or low birth weight (LBW) (OR 2.10, 95% CI 1.25-3.51) neonate, and offspring of them had an increased risk of weight for age z-score (WAZ) < -1 at 12 months of age (OR 1.79, 95%CI 1.01-3.19).
Offspring of mothers with bleeding and progesterone therapy were more likely to be a premature, SGA or LBW neonate, and had lower weight at 12 months of age. Progesterone supplementation may have no beneficial effect on improving adverse offspring outcomes related to early vaginal bleeding.
TMCHC was registered at clinicaltrials.gov as NCT03099837 on 4 April 2017.
孕激素被广泛用于改善与妊娠早期阴道出血相关的不良妊娠结局。然而，其有效性的证据尚无定论。
本研究纳入了 6615 对母婴，来自同济母婴队列（TMCHC）。在入组时获取了阴道出血和妊娠早期孕激素使用的信息。从医院记录中获得了出生结局。通过电话访谈收集了婴儿 12 个月时的体重。采用多变量逻辑回归来估计妊娠早期阴道出血和孕激素使用对出生结局以及婴儿 12 个月时的体重状况的影响。
21.4%（1418/6615）的参与者在妊娠早期出现出血，其中 47.5%（674/1418）接受了孕激素治疗。妊娠早期孕激素补充与后代结局之间没有显著关联。与无出血或任何治疗的妇女相比，有出血和孕激素治疗的妇女发生早产的风险增加（OR 1.74，95%CI 1.21-2.52），发生小于胎龄儿（SGA）（OR 1.46，95%CI 1.07-1.98）或低出生体重（LBW）（OR 2.10，95%CI 1.25-3.51）的风险增加，且这些婴儿在 12 个月时体重年龄 z 评分（WAZ）<-1 的风险增加（OR 1.79，95%CI 1.01-3.19）。
有出血和孕激素治疗的母亲的后代更有可能是早产儿、SGA 或 LBW 新生儿，并且在 12 个月时体重较低。孕激素补充可能对改善与妊娠早期阴道出血相关的不良后代结局没有有益作用。
TMCHC 于 2017 年 4 月 4 日在 clinicaltrials.gov 上注册，注册号为 NCT03099837。
