Effect of progesterone softgel combined with atosiban on serum index levels and maternal and infant outcome in patients of advanced maternal age with threatened premature delivery
Objective To investigate the effect of progesterone softgel combined with atosiban on serum levels of matrix metalloproteinase inhibitor-1(TIMP-1),nitric oxide(NO),prostaglandin E2(PGE2)and maternal and infant outcomes in patients of advanced maternal age with threatened premature delivery.Methods Clinical data of 102 patients of advanced maternal age with threatened premature delivery admitted to Yangzhou University Affiliated Hospital from January 2021 to December 2023 were retrospectively analyzed.These patients were divided into the combination group(n=45)and the control group(n=57)according to the treatment plan.The patients in the control group received conventional supportive treatment and magnesium sulfate treatment while those in the combination group received treatment with progesterone softgel combined with atosiban in addition to the usual supportive care.All the patients in both groups were followed up to pregnancy.The clinical symptom remission time,serum index-es before treatment and 10 days after treatment,maternal and infant outcomes and safety during treatment were compared between the two groups.Results The relief time of symptoms(abdominal pain,lumbar acid,bleeding relief)in the combination group was(3.23±0.68)d,(6.31±0.79)d,(5.29±0.87)d respectively,which was significantly shorter than that of(4.88±0.77)d,(7.73±0.88)d,(6.87±0.82)d in the control(t=11.307,8.461,9.406,all P＜0.05).After 10 days of treatment,the serum level of TIMP-1 was in-creased in both groups,and it was remarkably higher in the combination group than in the control((132.70±11.91)pg·mL-1 vs(112.53±13.23)pg·mL-1)(t=7.986,P＜0.05).The levels of NO and PGE2 were decreased in both groups,and they were significantly lower in the combination group than in the contol((23.05±3.61)μmol·L-1 vs(27.76±3.55)μmol·L-1,(41.75±5.20)pg·mL-1 vs(51.43±5.21)pg·mL-1)(t=6.604,9.325,both P＜0.05).Meanwhile,the success rate of fetal protection,neonatal body weight,Apgar score,gestational weeks of delivery were 100.00%(45/45),(2.89±0.38)kg,(9.35±0.19)points,(38.91±1.78)weeks in the combination group,which were all higher than those of 87.72%(50/57),(2.27±0.33)kg,(8.77±0.38)min,(37.89±1.21)weeks in the control(χ2=4.151,t=8.811,9.351,3.438,all P＜0.05).The preterm birth rate in the combination group was 4.44%(2/45),which was lower than that of 17.54%(10/57)in the control,showing statistically significant difference(χ2=4.157,P＜0.05).No significant difference was found in the incidence of adverse reactions between the two groups(13.33%(6/45)vs 7.02%(4/57))(χ2=1.156,P=0.282).Conclusion Progesterone softgel combined with atosiban can alleviate symptoms and improve maternal and infant outcomes in pa-tients of advance maternal age with threatened preterm delivery since it can improve the regulation of serum TIMP-1,NO and PGE2 levels.Furthermore,it is of high safety.
维普
万方数据
