Zhu Hao, Gu Weirong, Wang Bian, Hu Rong
Department of Obstetrics, Obstetrics & Gynecology Hospital of Fudan University, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Shanghai, China.
Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated with JiaoTong University School of Medicine, Shanghai, China.
PLoS One. 2025 Jul 9;20(7):e0328008. doi: 10.1371/journal.pone.0328008. eCollection 2025.
This retrospective cohort study aimed to evaluate the effects and adverse outcomes of continuous and repeated treatment with atosiban in twin pregnancies with threatened preterm labor.
The study was conducted at the Department of Obstetrics, Obstetrics and Gynecology, Hospital of Fudan University and included 90 twin pregnancies diagnosed with threatened preterm labor between January 2018 and December 2022. The pregnancies received atosiban tocolytic treatment. The data was divided into two groups based on whether continuous and repeated treatment was administered. Delivery outcomes, as well as maternal and neonatal complications, were analyzed. Propensity score matching (PSM) was employed to create comparable groups.
Out of the 90 women, 34 received continuous and repeated treatment, while 56 did not. After PSM, 33 women who received continuous and repeated treatment were matched with 33 women who did not. The continuous and repeated treatment group showed a significant prolongation of pregnancy (p = 0.001) with a hazard ratio of 0.58 (95%CI, 0.35-0.96), and a later gestational age (p = 0.042). These patients also had a more complete cycle of antenatal steroids (p = 0.002) and a lower proportion of cases requiring operative delivery due to fetal distress (OR=0.14 [0.03-0.75], p = 0.004). Additionally, neonates in the continuous and repeated treatment group had a lower rate of admission to the neonatal intensive care unit (NICU) (OR=0.41 [0.19-0.89], p = 0.023).
This propensity score-matched study suggests that continuous and repeated treatment with atosiban may effectively prolong pregnancy in cases of twin pregnancies with threatened preterm labor. Continuous and repeated treatment with atosiban was associated with lower fetal distress and lower NICU admission but no effect in adverse neonatal outcomes as well as the incidence of chorioamnionitis.
本回顾性队列研究旨在评估阿托西班持续重复治疗对双胎妊娠先兆早产的疗效及不良结局。
本研究在复旦大学附属妇产科医院产科进行，纳入2018年1月至2022年12月期间诊断为双胎妊娠先兆早产的90例患者。这些妊娠接受了阿托西班保胎治疗。根据是否接受持续重复治疗将数据分为两组。分析分娩结局以及母婴并发症。采用倾向评分匹配（PSM）创建可比组。
90例女性中，34例接受了持续重复治疗，56例未接受。PSM后，33例接受持续重复治疗的女性与33例未接受的女性相匹配。持续重复治疗组的妊娠时间显著延长（p = 0.001），风险比为0.58（95%CI，0.35 - 0.96），且孕周更大（p = 0.042）。这些患者的产前类固醇治疗疗程也更完整（p = 0.002），因胎儿窘迫需要手术分娩的病例比例更低（OR = 0.14 [0.03 - 0.75]，p = 0.004）。此外，持续重复治疗组新生儿入住新生儿重症监护病房（NICU）的比例更低（OR = 0.41 [0.19 - 0.89]，p = 0.023）。
这项倾向评分匹配研究表明，阿托西班持续重复治疗可能有效延长双胎妊娠先兆早产患者的孕周。阿托西班持续重复治疗与更低的胎儿窘迫发生率和更低的NICU入住率相关，但对新生儿不良结局以及绒毛膜羊膜炎的发生率无影响。
