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1.南通大学附属妇幼保健院药学部,江苏 南通 226018
2.南通大学药学院,江苏 南通 226001
3.南通市遗传与生殖医学研究所,江苏 南通 226007
4.南通大学附属妇幼保健院产科,江苏 南通 226018
5.南通大学信息科学技术学院,江苏 南通 226001
主管药师,硕士。研究方向:临床药学。E-mail:1522281926@qq.com
副主任药师,副教授。研究方向:临床药学、医学统计学。E-mail:gulinqi@ntu.edu.cn
收稿日期:2024-10-23,
修回日期:2025-02-20,
录用日期:2025-02-21,
纸质出版日期:2025-03-30
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秦燕,顾锦华,诸静,等.妊娠早期使用口服孕激素类药物与妊娠期糖尿病的关联性分析[J].中国药房,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.
秦燕,顾锦华,诸静,等.妊娠早期使用口服孕激素类药物与妊娠期糖尿病的关联性分析[J].中国药房,2025,36(06):721-726. DOI: 10.6039/j.issn.1001-0408.2025.06.14.
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.
目的
2
探讨妊娠早期使用口服孕激素类药物与妊娠期糖尿病(GDM)之间的关联性。
方法
2
采用真实世界回顾性队列研究方法,纳入2022年1月至2023年1月在南通大学附属妇幼保健院完成口服葡萄糖耐量试验(OGTT)检查的孕妇,根据是否在妊娠早期使用口服孕激素类药物将其分为给药组和对照组,采用1∶1倾向得分匹配(PSM)控制混杂因素,采用Logistic回归和线性回归进行药物因素(是否使用口服孕激素类药物、服药天数、剂量、药物品种)与结局指标(妊娠晚期是否发生GDM、空腹血糖值和OGTT 1、2 h血糖值)的关联性分析。
结果
2
PSM前两组共纳入孕妇709例;PSM后,给药组和对照组各纳入256例。关联性分析结果显示,使用口服孕激素类药物与GDM的发生之间无明显关联性(
P
>0.05),但与OGTT 1 h血糖值存在显著关联性[
β
=0.965,95%置信区间(CI)(0.007,1.922),
P
<0.05
]
,使用药物具体为地屈孕酮片[
β
=0.977,95%CI(0.009,1.944),
P
<0.05
]
和黄体酮软胶囊[
β
=1.089,95%CI(0.077,2.102),
P
<0.05
]
;其余药物因素与结局指标之间均无显著关联性(
P
>0.05)。
结论
2
妊娠早期使用口服孕激素类药物与GDM的发生之间无显著关联性;妊娠晚期血糖值,特别是OGTT 1 h血糖值与黄体酮软胶囊、地屈孕酮片存在一定关联性。
OBJECTIVE
2
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.
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 .
张娴 , 侯晓怡 , 琚娜娜 , 等 . 妊娠早期黄体酮的使用对妊娠期糖尿病的影响 [J ] . 中国新药与临床杂志 , 2022 , 41 ( 9 ): 539 - 542 .
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 .
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