Joensuu Johanna M, Ylikorkala Olavi, Venetkoski Minttu, Gissler Mika, Savolainen-Peltonen Hanna, Mikkola Tomi S
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki FI-00290, Finland.
Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki FI-00271, Finland.
J Clin Endocrinol Metab. 2025 Jun 17;110(7):1946-1951. doi: 10.1210/clinem/dgae677.
Women with a history of preeclamptic pregnancy are predisposed to later occlusive vascular diseases.
We compared the use of cyclic progestins or levonorgestrel-releasing intrauterine device (LNG-IUD) for treatment of menstrual cycle abnormalities between premenopausal women with and without a prior preeclamptic pregnancy.
Register-based cohort study during 1994 to 2019 of oral progestin or LNG-IUD in Finnish women with (n = 31 688) and without (n = 91 726) prior preeclampsia in 1969 to 1993. Cyclic progestin or LNG-IUD use and its association with future use of menopausal hormone therapy (MHT).
Women with prior preeclampsia had used cyclic progestins more often (23.5% vs 9.1%; P < .001) and initiated the use at younger ages (41.8 years, SD 6.3 vs 45.9 years, 3.1; P < .001) than control women. Also, LNG-IUD was inserted more frequently (P < .001) in women with prior preeclampsia (9.3%) than in controls (4.7%). Cyclic progestin or LNG-IUD use was accompanied by significant 37% to 90% elevations in future MHT use.
Increased use of cyclic progestins and LNG-IUD in premenopausal women with a history of preeclamptic pregnancy can be seen as indirect evidence of earlier onset of ovulatory dysfunction. This may contribute to the elevated risk of endometrial cancer in these women. Our findings may indicate an additional late sequela of preeclamptic pregnancy.
有子痫前期妊娠史的女性日后易患闭塞性血管疾病。
我们比较了在有或无既往子痫前期妊娠史的绝经前女性中，使用周期性孕激素或左炔诺孕酮宫内节育器（LNG-IUD）治疗月经周期异常的情况。
基于登记的队列研究，研究对象为1994年至2019年期间芬兰有（n = 31688）或无（n = 91726）1969年至1993年子痫前期病史的女性使用口服孕激素或LNG-IUD的情况及其与未来绝经激素治疗（MHT）使用的关联。
有子痫前期病史的女性比对照女性更频繁地使用周期性孕激素（23.5%对9.1%；P <.001），且开始使用的年龄更小（41.8岁，标准差6.3对45.9岁，3.1；P <.001）。此外，有子痫前期病史的女性（9.3%）比对照女性（4.7%）更频繁地插入LNG-IUD（P <.001）。使用周期性孕激素或LNG-IUD伴随着未来MHT使用显著升高37%至90%。
有子痫前期妊娠史的绝经前女性中周期性孕激素和LNG-IUD使用的增加可被视为排卵功能障碍更早发生的间接证据。这可能导致这些女性子宫内膜癌风险升高。我们的发现可能表明子痫前期妊娠的另一种晚期后遗症。
