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, 8 ), as well as thyroid hormones ( 9 ) in the human vocal fold. Furthermore, a few research papers hypothesize the voice changes in diabetes mellitus (DM) due to its microvascular complications. The multifaceted mechanism of possible voice changes
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Introduction
To investigate whether synthetic (s) glucocorticoids (GCs) administered between the 24th and the 34th gestational weeks in pre-term labor might precipitate labor, studies on sGCs administration were reviewed. The physiology of endogenous glucocorticoid-related increase in fetal–maternal circulation and its association with labor, followed by a scoping review of studies on exogenous sGCs administered for fetal lung maturation and the timing of labor, were included.
Materials and methods
The methodology of systematic reviews was followed. MEDLINE, Cochrane Library, and Google Scholar databases were searched until October 2023, for original studies investigating the administration of sGCs in pregnancies risking pre-term labor. Duplicates were removed, and 1867 abstracts were excluded as irrelevant. Six controlled and four non-controlled studies were included. The index group consisted of 6001 subjects and 7691 controls in the former, while in the latter, the index group consisted of 2069 subjects.
Results
In three out of the six controlled studies, gestational age at labor was significantly lower in sGC-treated women than in controls, while in three studies, gestational age at labor was lower in sGC-treated women than in controls, with a trend toward statistical significance. In one study, gestational age at labor was significantly lower in controls than in sGC-treated women. In the non-controlled studies, the majority of women delivered less than 1 week from the day of sGC administration.
Conclusions
In this scoping review, studies lack homogeneity. However, in the controlled studies, a pattern of earlier labor emerges among sGC-treated pregnant women. The use of multiple courses of antenatal sGCs appears to be associated with precipitated labor. Their use should be carefully weighed. Carefully designed trials should examine this ongoing scientific query.
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Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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established based on Rotterdam criteria. Women attending this clinic are screened, managed, or referred to a relevant specialist for type 2 diabetes mellitus, hypertension, coronary heart disease, lipid disorders, and venous thromboembolic disease. In addition
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measurements. Blood pressure was measured in the supine position after 5 min of rest at baseline and follow-up. Similar procedures were performed at both visits ( 13 ). Diabetes mellitus type II (T2D) and hypertension were defined according to the World Health
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Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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.71 Dyslipidemia, n (%) 46 (49.5) 95 (40.9) 49 (53.8) 0.16 0.04 Insulin resistance, n (%) 9 (56.3) 4 (3.2) 51 (70.8) <0.001 <0.001 Type 2 diabetes mellitus, n (%) 3 (3.3) 3 (2.5) 7 (8.3) 0.70 0.09 Nulliparous
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with type 2 diabetes mellitus ( 26 ). In contrast, increased levels of circulating irisin appears to be linked with improved glucose homeostasis by reducing insulin resistance ( 27 ), indicating irisin performs a possible compensatory role in glucose
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Unit of Gynecology and Obstetrics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Rome, Italy
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Medical Department Pronokal Group, Barcelona, Spain
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Unit of Gynecology and Obstetrics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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. Exclusion criteria ( Fig. 1 ) were any of the following: type 1 diabetes mellitus, type 2 diabetes mellitus treated with insulin, obesity caused by endocrine diseases unrelated to PCOS or drug-induced obesity, any weight loss diet or estro-progestin therapy
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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patients with diabetes mellitus type 2, prostate cancer, and breast cancer at baseline; and (iv) excluding studies with only dialysis patients. If data were sufficient (≥2 studies per subgroup), subgroup analyses were performed for age, sex, body mass index
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.5%) 18 (23.1%) Common pregnancy complications Hypertensive disorders of pregnancy 10 (18.9%) 12 (15.4%) 0.60 Gestational diabetes mellitus 4 (7.5%) 15 (19.2%) 0.06 Common comorbidities Asthma 3
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, diabetes mellitus (DM), nonalcoholic fatty liver disease (NAFLD), cardiovascular disease, endometrial lesions, and hypertension during pregnancy ( 2 , 3 , 4 , 5 ). The etiology of PCOS is unclear at present, though environmental and genetic factors are