{"id":51,"title":"Periconceptual Progesterone Use and Hypertensive Disorders of Pregnancy: A Population-Based Cohort Study","title_zh":"围受孕期孕酮使用与妊娠期高血压疾病：一项基于人群的队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42987862","doi":"10.1111/1471-0528.70355","pmid":"42987862","journal":"BJOG","kind":"paper","lang":"en","published_at":"2026-11-05T00:00:00+00:00","fetched_at":"2026-11-08T03:43:52+00:00","authors":["Atkinson JA","Hiscock RJ","Forsythe A","Gordon HG","Myers J","Walker SP","Vollenhoven BJ","Tong S","Hastie RM","Lindquist AC"],"primary_topic":"repro-endo","topics":[{"slug":"repro-endo","score":4.0,"hits":["progesterone"]},{"slug":"early-pregnancy","score":2.0,"hits":["first trimester","preeclampsia"]},{"slug":"art-clinical","score":1.0,"hits":["assisted reproductive"]}],"topic_score":4.0,"preference_score":0.0,"preference_labels":[],"llm_score":74.0,"final_score":78.0,"score_dims":{"novelty":68,"rigor":86,"impact":62,"relevance":88,"translation":64},"recommend_reason":"大样本、全州链接数据与规范加权分析，为围受孕期孕酮与妊娠期高血压/子痫前期风险提供了较高质量观察证据；但效应主要见于妊娠期高血压且作者判断临床意义有限，适合作为咨询与后续研究参考。","keywords":["围受孕期","孕酮","妊娠期高血压","子痫前期","辅助生殖","队列研究"],"selected":1,"story_id":64,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":"bjog","journal_tier":"field-top","journal_if":4.7,"is_mock":false,"summary_zh":"该研究利用澳大利亚维多利亚州2009—2020年妊娠与出生数据，关联医院及处方数据，纳入386 475名初产妇，比较围受孕期（孕前6周至孕早期末）使用孕酮者与未使用者。采用逆概率加权回归校正混杂后，孕酮使用与任何新发妊娠期高血压疾病风险降低相关（aRR 0.81），主要来自妊娠期高血压风险下降（aRR 0.60），子痫前期无显著变化；仅分析辅助生殖妊娠时结果相似。作者认为统计学显著但临床意义可能有限。","summary":"OBJECTIVE: To investigate whether periconceptual use of progesterone is associated with an altered risk of new-onset hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, or superimposed preeclampsia). DESIGN: Population-based cohort study using statewide pregnancy and birth data from Victoria, Australia, linked with hospital and medication prescribing data. SETTING: Victoria, Australia (2009-2020). POPULATION: Nulliparous women who gave birth between 2009 and 2020 in Victoria, Australia. Women with missing delivery dates, medicine dispensation dates, or who were exposed to progesterone in the second or third trimester were excluded. METHODS: We compared nulliparous women exposed to progesterone in the periconceptual period (6 weeks preconception until the end of the first trimester) with those not exposed to progesterone. Inverse probability-weighted regression adjustment was used to control for confounding factors and investigate the effect of progesterone on the risk of preeclampsia (including superimposed preeclampsia) and gestational hypertension. MAIN OUTCOME MEASURES: Development of preeclampsia or gestational hypertension. RESULTS: Among 386 475 pregnancies, 5657 (1.5%) women used progesterone in the periconceptual period. Progesterone use was associated with a statistically significant reduction in the risk of any new onset hypertensive disorders of pregnancy (adjusted risk ratio [aRR] 0.81 [95% confidence interval [CI] 0.67, 0.98]; adjusted risk difference [aRD] -1.72% [95% CI -3.21%, -0.24%]). Investigating type of hypertension, we found progesterone use was associated with a 1.69% absolute reduced risk of gestational hypertension (aRR 0.60 [95% CI 0.43, 0.83]; aRD -1.69% [95% CI -2.52%, -0.86%]) but no significant change was observed for preeclampsia (aRR 0.97 [95% CI 0.75, 1.25]; aRD -0.13% [95% CI -1.49%, 1.23%]). Restricting our analyses to pregnancies conceived via assisted reproductive technology only, we found similar results, with a statistically significant reduction in the risk of gestational hypertension (aRR 0.80 [95% CI 0.67, 0.95]; aRD -1.02% [95% CI -1.73%, -0.30%]) but not preeclampsia (aRR 0.96 [95% CI 0.83, 1.11]; aRD -0.25% [95% CI -1.23%, 0.72%]). CONCLUSIONS: Among 386 475 nulliparous women, we found periconceptual progesterone use to be associated with a statistically significant reduction in the risk of gestational hypertension, but not preeclampsia. However, these findings are unlikely to be clinically meaningful.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}