QIN Yan,GU Jinhua,ZHU Jing,et al.Analysis of the association between the use of oral progesterone drugs in early pregnancy and gestational diabetes mellitus[J].ZHONGGUO YAOFANG,2025,36(06):721-726.
QIN Yan,GU Jinhua,ZHU Jing,et al.Analysis of the association between the use of oral progesterone drugs in early pregnancy and gestational diabetes mellitus[J].ZHONGGUO YAOFANG,2025,36(06):721-726. DOI: 10.6039/j.issn.1001-0408.2025.06.14.
Analysis of the association between the use of oral progesterone drugs in early pregnancy and gestational diabetes mellitus
To explore the association between the use of oral progesterone drugs in early pregnancy and gestational diabetes mellitus (GDM).
METHODS
2
Through real-world retrospective cohort research method, pregnant women who underwent the oral glucose tolerance test (OGTT) at the Affiliated Maternal and Child Health Hospital of Nantong University between January 2022 and January 2023 were enrolled. Based on whether oral progesterone drugs were used in early pregnancy, they were divided into treatment group and control group; propensity score matching (PSM) with a 1∶1 ratio was employed to control for confounding factors; Logistic regression and linear regression were employed to analyze the association between drug factors (whether use of oral progesterone drug, duration of medication, dosage, and drug type) and outcome indicators (occurrence of GDM, fasting blood glucose levels, and OGTT 1 and 2 h blood glucose levels in late pregnancy).
RESULTS
2
A total of 709 pregnant women were enrolled in the two groups before PSM; after PSM, 256 cases were included in both the treatment group and the control group. The results of association analysis indicated that there was no significant association between the use of oral progesterone drugs and GDM (
P
>0.05); but a significant correlation was found with OGTT 1 h blood glucose levels [
β
=0.965, 95%CI (0.007,1.922),
P
<0.05
]
, specifically with Dydrogesterone tablets [
β
=0.977, 95%CI (0.009, 1.944),
P
<0.05
]
and Progesterone soft capsules [
β
=1.089, 95%CI (0.077, 2.102),
P
<0.05
]
. There was no significant correlation between other drug factors and outcome indicators (
P
>0.05).
CONCLUSIONS
2
The use of oral progestogen drugs in early pregnancy is not significantly associated with GDM. The blood glucose levels in late pregnancy, especially OGTT 1 h blood glucose levels, have a certain correlation with Progesterone soft capsules and Dydrogesterone tablets.
关键词
Keywords
references
MODZELEWSKI R , STEFANOWICZ-RUTKOWSKA M M , MATUSZEWSKI W , et al . Gestational diabetes mellitus:recent literature review [J ] . J Clin Med , 2022 , 11 ( 19 ): 5736 .
WANG J J , CHEN K , JIN X Y , et al . Prognostic factors for cesarean section outcome of pregnant women with gestational diabetes mellitus:a systematic review and meta-analysis [J ] . Diabetes Metab Syndr Obes , 2019 , 12 : 913 - 929 .
STACEY T , TENNANT P , MCCOWAN L , et al . Gestational diabetes and the risk of late stillbirth:a case-control study from England,UK [J ] . BJOG , 2019 , 126 ( 8 ): 973 - 982 .
O’BRIEN J M , LEWIS D F . Prevention of preterm birth with vaginal progesterone or 17-alpha-hydroxyprogesterone caproate:a critical examination of efficacy and safety [J ] . Am J Obstet Gynecol , 2016 , 214 ( 1 ): 45 - 56 .
KUON R J , SHI S Q , MAUL H , et al . Pharmacologic actions of progestins to inhibit cervical ripening and prevent delivery depend on their properties,the route of admini-stration,and the vehicle [J ] . Am J Obstet Gynecol , 2010 , 202 ( 5 ): 455.e1 - 455.e9 .
CARITIS S N , VENKATARAMANAN R , THOM E , et al . Relationship between 17-alpha hydroxyprogesterone caproate concentration and spontaneous preterm birth [J ] . Am J Obstet Gynecol , 2014 , 210 ( 2 ): 128.e1 - 128.e6 .
American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins-Gynecology . ACOG practice bulletin No. 200:early pregnancy loss [J ] . Obstet Gynecol , 2018 , 132 ( 5 ): e197 - e207 .
ZHANG X , HOU X Y , JU N N , et al . Effects of progeste-rone treatment on gestational diabetes mellitus in early pregnancy [J ] . Chin J New Drugs Clin Remedies , 2022 , 41 ( 9 ): 539 - 542 .
PERGIALIOTIS V , BELLOS I , HATZIAGELAKI E , et al . Progestogens for the prevention of preterm birth and risk of developing gestational diabetes mellitus:a meta-analysis [J ] . Am J Obstet Gynecol , 2019 , 221 ( 5 ): 429 - 436 .
WU H L , ZHANG S Y , LIN X N , et al . Pregnancy-related complications and perinatal outcomes following progeste-rone supplementation before 20 weeks of pregnancy in spontaneously achieved singleton pregnancies:a syste-matic review and meta-analysis [J ] . Reprod Biol Endocrinol , 2021 , 19 ( 1 ): 165 .
GARINO F , GOTTERO C , BALBO M , et al . Pregnancy and diabetes in Turin:lights and shadows from real life data [J ] . Endocr Metab Immune Disord Drug Targets , 2024 , 24 ( 17 ): 18 .
LI L , WANG K , WANG M X , et al . The maternal drug exposure birth cohort(DEBC)in China [J ] . Nat Commun , 2024 , 15 : 5312 .
Jr LOWE W L , KARBAN J . Genetics,genomics and meta-bolomics:new insights into maternal metabolism during pregnancy [J ] . Diabet Med , 2014 , 31 ( 3 ): 254 - 262 .
BERGMAN M , TUOMILEHTO J . International diabetes federation position statement on the 1-hour post-load plasma glucose for the diagnosis of intermediate hyperglycaemia and type 2 diabetes [J ] . Diabetes Res Clin Pract , 2024 , 210 : 111636 .
DEVALL A J , PAPADOPOULOU A , PODESEK M , et al . Progestogens for preventing miscarriage:a network meta-analysis [J ] . Cochrane Database Syst Rev , 2021 , 4 ( 4 ): CD013792 .
WU P , WANG Y , YE Y , et al . Liver biomarkers,lipid meta-bolites,and risk of gestational diabetes mellitus in a prospective study among Chinese pregnant women [J ] . BMC Med , 2023 , 21 ( 1 ): 150 .