【摘要】 目的 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 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 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 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。更多还原

【Abstract】 OBJECTIVE To explore the association between the use of oral progesterone drugs in early pregnancy and gestational diabetes mellitus(GDM). METHODS 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 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 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.更多还原