Glycemic control following two regimens of antenatal corticosteroids in mild gestational diabetes: a randomized controlled trial

Sukarna, Nuraini; Tan, Peng Chiong; Hong, Jesrine Gek Shan; Sulaiman, Sofiah; Omar, Siti Zawiah

doi:10.1007/s00404-020-05950-3

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…A small randomized controlled trial demonstrated fewer hyperglycemic episodes in patients who received 12 mg every 12 h for 1 day when compared to those who received 6mg every 12 h for 2 days, suggesting that higher doses for a shorter period of time is more favorable for the metabolic profile of pregnant patients with gestational diabetes receiving systemic corticosteroids. However, data are still limited [ 65 ].…”

Section: Covid-19 Epidemiological Data and Clinical Concerns In Pregnancy Thus Farmentioning

confidence: 99%

SARS-CoV-2 and the Immune Response in Pregnancy with Delta Variant Considerations

Rangchaikul

Venketaraman

2021

Infectious Disease Reports

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As of September 2021, there has been a total of 123,633 confirmed cases of pregnant women with SARS-CoV-2 infection in the US according to the CDC, with maternal death being 2.85 times more likely, pre-eclampsia 1.33 times more likely, preterm birth 1.47 times more likely, still birth 2.84 times more likely, and NICU admission 4.89 times more likely when compared to pregnant women without COVID-19 infection. In our literature review, we have identified eight key changes in the immunological functioning of the pregnant body that may predispose the pregnant patient to both a greater susceptibility to SARS-CoV-2, as well as a more severe disease course. Factors that may impede immune clearance of SARS-CoV-2 include decreased levels of natural killer (NK) cells, Th1 CD4+ T cells, plasmacytoid dendritic cells (pDC), a decreased phagocytic index of neutrophil granulocytes and monocytes, as well as the immunomodulatory properties of progesterone, which is elevated in pregnancy. Factors that may exacerbate SARS-CoV-2 morbidity through hyperinflammatory states include increases in the complement system, which are linked to greater lung injury, as well as increases in TLR-1 and TLR-7, which are known to bind to the virus, leading to increased proinflammatory cytokines such as IL-6 and TNF-α, which are already elevated in normal pregnant physiology. Other considerations include an increase in angiotensin converting enzyme 2 (ACE2) in the maternal circulation, leading to increased viral binding on the host cell, as well as increased IL-6 and decreased regulatory T cells in pre-eclampsia. We also focus on how the Delta variant has had a concerning impact on SARS-CoV-2 cases in pregnancy, with an increased case volume and proportion of ICU admissions among the infected expecting mothers. We propose that the effects of the Delta variant are due to a combination of (1) the Delta variant itself being more transmissible, contagious, and efficient at infecting host cells, (2) initial evidence pointing to the Delta variant causing a significantly greater viral load that accumulates more rapidly in the respiratory system, (3) the pregnancy state being more susceptible to SARS-CoV-2 infection, as discussed in-depth, and (4) the lower rates of vaccination in pregnant women compared to the general population. In the face of continually evolving strains and the relatively low awareness of COVID-19 vaccination for pregnant women, it is imperative that we continue to push for global vaccine equity.

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Section: Covid-19 Epidemiological Data and Clinical Concerns In Pregnancy Thus Farmentioning

confidence: 99%

SARS-CoV-2 and the Immune Response in Pregnancy with Delta Variant Considerations

Rangchaikul

Venketaraman

2021

Infectious Disease Reports

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“…Studies were conducted in Europe (34%), the USA (14%) and China (14%), Australia/New Zealand (11%) and Jordan, Israel and Oman (23%). Twenty-seven (77%) of the studies reporting a PRO as a primary or secondary outcome were conducted in women with a diagnosis of GDM [31][32][33][34][35][36]39,40,[42][43][44][45][46][47][48][49][50][51][52][53][54][58][59][60]62,64,65], and the remainder were conducted in women with pregestational diabetes or a combination of both GDM and pregestational diabetes.…”

Section: Descriptive Statisticsmentioning

confidence: 99%

“…Eight studies (23%) evaluated diabetes specific educational interventions (e.g. dietary, lifestyle, exercise or medication adjustment education) [33,[39][40][41]43,49,53,54]; three (8.6%) evaluated exercise [35,46,54]; two (5.7%) evaluated pharmaceutical products [58,62] and two (5.7%) evaluated breastfeeding supports delivered during pregnancy [63,64]. The remaining studies evaluated self-care [45], self-efficacy training [47], acupuncture [36], cognitive behavioural therapy [44], breathing exercises [52] and counselling interventions [50].…”

Section: Descriptive Statisticsmentioning

confidence: 99%

“…In total 26 studies (74.3%) listed a PRO as a primary outcome, nine studies (25.7%) included a PRO as a secondary endpoint [57][58][59][60][61][62][63][64][65], and two studies included PROs as both primary and secondary endpoints [42,43]. Where a study listed PROs as both primary and secondary outcomes they were evaluated as primary outcomes.…”

Section: Descriptive Statisticsmentioning

confidence: 99%

See 1 more Smart Citation

Quality of patient-reported outcome reporting in trials of diabetes in pregnancy: A systematic review

Newman

Kgosidialwa

Dervan

et al. 2022

Diabetes Research and Clinical Practice

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Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth

Williams

Ramson²,

Brownfoot

2022

Cochrane Database of Systematic Reviews

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Glycemic control following two regimens of antenatal corticosteroids in mild gestational diabetes: a randomized controlled trial

Cited by 6 publications

References 26 publications

SARS-CoV-2 and the Immune Response in Pregnancy with Delta Variant Considerations

SARS-CoV-2 and the Immune Response in Pregnancy with Delta Variant Considerations

Quality of patient-reported outcome reporting in trials of diabetes in pregnancy: A systematic review

Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth

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