早孕期口服地屈孕酮与新鲜周期辅助生殖单胎孕妇子痫前期发生的关联性

目的探究早孕期口服地屈孕酮与新鲜周期辅助生殖单胎孕妇子痫前期发病的关联性。方法收集2008年1月—2016年6月接受胚胎移植新鲜周期辅助生殖且本院分娩的756例单胎孕妇病例资料进行回顾性队列研究。按照早孕期孕激素黄体支持是否加用地屈孕酮,分为地屈孕酮组(黄体酮/雪诺酮+地屈孕酮)196例和对照组(黄体酮/雪诺酮)560例,比较组间孕妇子痫前期的发病率。采用Logistic回归分析,探究地屈孕酮与子痫前期发生的关联关系。结果地屈孕酮组子痫前期发病率(1.0%)低于对照组(4.5%,P=0.025)。地屈孕酮组配偶年龄≥40岁、孕妇合并症的比例均高于对照组(P值分别为0.037、0.048)。将地屈孕酮、配偶年龄及孕妇合并症纳入Logistic回归分析。多因素分析显示仅地屈孕酮和子痫前期有统计学意义的关联(OR=0.221,95%CI=0.052~0.940,P=0.041)。结论早孕期口服地屈孕酮是新鲜周期辅助生殖孕妇子痫前期发生的保护因素。

Correlation between taking dydrogesterone in the first trimester and preeclampsia in singleton pregnancy following fresh cycle assisted reproduction

Objective To investigate the correlation between taking dydrogesterone in the first trimester and preeclampsia in singleton pregnancy following fresh cycle assisted reproduction.Methods A retrospective cohort study was conducted on the 756 cases of singleton pregnancy who received fresh cycle assisted reproduction and delivered in our hospital from January 2008 to Jtme 2016.According to the usage of dydrogesterone,the patients were divided into the dydrogesterone group (progesterone/progesterone vaginal gel and dydrogesterone) of 196 cases and control group (progesterone/progesterone vaginal gel) of 560 cases.The incidence ofpreeclampsia in two groups was compared.The Logistic regression analysis was used to investigate the correlation between taking dydrogesterone in the first trimester and preeclampsia.Results The incidence of preeclampsia was significantly lower in the dydrogesterone group (1.0％) than that in control group (4.5％,P=0.025).Both the spouses aged more than forty years and the gravids with complications were more in the dydrogesterone group compared with control group (P=0.037,P=0.048).The multivariate analysis showed that taking dydrogesterone in the first trimester was correlated with preeclampsia (OR=0.221,95％ CI=0.052～0.940,P=0.041).Conclusion Taking dydrogesterone in the first trimester was a protective factor for preeclampsia in singleton pregnancy following fresh cycle assisted reproduction.