Numerous systematic reviews have examined the non-genetic factors associated with the risk of miscarriage. Therefore, this study aimed to conduct an umbrella review on non-genetic factors associated with the risk of miscarriage. Scopus, PubMed, Embase, and Web of Science were searched until 2025 and the systematic review and meta-analysis articles that were conducted on observational studies were extracted. Quality assessment of the selected review articles was done by AMSTAR. For each selected meta-analysis, the summary effect size with the 95

Background: Endometriosis has potential negative effects on the fertility, mental, and sexual health of women. Since the conducted studies have not comprehensively addressed the needs and strategies to improve sexual health, and to design the necessary programs and interventions for this group of women. Objective: The present study aims to design and implement interventions to improve sexual health of women with endometriosis. Materials and Methods: This sequential mixed-methods study comprises 4 phases. Phase 1 is a qualitative study using semi-structured interviews to explore needs and strategies from the perspectives of women with endometriosis and healthcare providers. Phase 2 involves a systematic review to identify additional evidence-based strategies. Phase 3 integrates findings from phases 1 and 2 with prioritization by a multidisciplinary expert panel using the Delphi technique, to develop a comprehensive intervention program. Phase 4 is a randomized controlled trial to evaluate the effectiveness of the developed intervention on sexual function and sexual quality of life compared to routine care. Conclusion: This protocol aims to develop a comprehensive, evidence-based care program integrating qualitative insights, systematic review findings, and multidisciplinary expert opinions, and to evaluate its effectiveness in improving the sexual health of women with endometriosis.

Endometriosis profoundly impairs sexual function in women. Despite evidence supporting motivational interviewing (MI) and pelvic floor muscle training (PFMT) separately, no study has directly compared these two approaches on sexual function in endometriosis. This trial compared the effectiveness of MI versus PFMT on sexual function in women with endometriosis. This parallel-group, active-controlled randomized trial was conducted at Baghaeipour Clinic, Yazd, Iran (October 2024 – April 2025). Sixty women with endometriosis (30 per group) were randomly assigned to six weekly 90‑minute sessions of MI or PFMT delivered virtually. Both groups received routine care including lubricant gel. Sexual function was measured using the Female Sexual Function Index (FSFI) at baseline (T0), immediately post‑intervention (week 6, T1), and two months after intervention completion (week 14, T2). Data were analyzed using independent t‑tests, Chi‑square tests, and repeated‑measures ANOVA. Fifty‑four participants (27 per group) completed the study. Both groups were homogeneous at baseline. In the MI group, mean FSFI scores improved from baseline to T1 (17.82 ± 6.80 to 22.07 ± 7.41, p < 0.001) and to T2 (26.10 ± 3.35, p < 0.001), with sustained improvement from T1 to T2 (p < 0.001). In the PFMT group, scores improved from baseline to T1 (17.07 ± 6.04 to 23.43 ± 5.28, p < 0.001) and to T2 (24.30 ± 5.62, p < 0.001), but the T1‑to‑T2 change was not significant (p = 0.466). No significant between‑group differences were found at any time point (p > 0.05). Time had a significant effect (p < 0.001), but neither group (p = 0.880) nor time‑group interaction (p = 0.418) was significant. Both motivational interviewing and pelvic floor muscle training were associated with improved sexual function in women with endometriosis. No statistically significant difference was observed between the interventions. Both approaches offer non-invasive, complementary options for managing endometriosis-related sexual dysfunction, though further large-scale research is needed to confirm these findings and establish comparative long-term efficacy. This research was registered in the Iranian Registry of Clinical Trials (IRCT20240623062218N1) on 2024-09-14. Endometriosis can negatively affect sexual health and quality of life. This study compared two non-drug approaches, motivational interviewing (MI) and pelvic floor muscle training (PFMT), to improve sexual function in women with endometriosis. Sixty women were randomly assigned to receive six weekly online sessions of either MI or PFMT. Sexual function was assessed at baseline, immediately after the six-week intervention, and at the two-month follow-up. Fifty-four women completed the study. Sexual function improved significantly over time in both groups. However, there was no significant difference between the two interventions, and neither approach was shown to be superior. These findings suggest that both MI and PFMT may be feasible and useful complementary approaches for managing sexual dysfunction related to endometriosis. Larger studies with longer follow-up and appropriate control groups are needed to confirm these findings.

Objective:Urinary incontinence (UI) is a common issue during pregnancy. Pelvic floor muscle training (PFMT) may offer an effective solution for managing this condition. This study aimed to evaluate the effect of PFMT on reducing UI symptoms in pregnant women. Materials and Methods:This study was conducted on 40 UI pregnant women with gestational diabetes mellitus (GDM) and 40 UI pregnant women without GDM. The participants in the experimental group were treated for 10 weeks in the third trimester, whereas the control groups received an educational pamphlet. Quality of life and UI severity were assessed using questionnaires, and pelvic floor muscle performance was measured through ultrasound-based bladder base displacement. Assessments were performed before treatment, after 10 weeks, and 2 weeks postpartum. Results:In the non-diabetic group, significant reductions in UI symptoms were observed at the end of the third trimester and 2 weeks postpartum [adjusted difference -7.56, 95% confidence interval (CI) -10.62 to -4.49, p<0.001]. However, in the diabetic group, a reduction was noted, but it was not statistically significant. Additionally, the intervention positively impacted quality of life in the non-diabetic group (adjusted difference 30.8, 95% CI 17.6 to 44.1, p<0.001) but not in the diabetic group. Notably, no significant improvement in pelvic floor muscle performance was observed in either group. Conclusion:This study suggests that PFMT can be more effective than routine pamphlets in reducing UI symptoms and improving the quality of life in pregnant women, both with and without GDM. Further research is needed to explore effects on pelvic floor muscle performance.

INTRODUCTION:Lower urinary tract symptoms (LUTS) are a common and significant concern during pregnancy; however, research on LUTS in pregnant women in Iran, particularly in Yazd, is limited. This study aimed to investigate the prevalence and associated factors of LUTS in pregnant women in Yazd, Iran. METHODS:A cross-sectional study was conducted among pregnant women attending routine antenatal visits in Yazd between October 2022 and May 2023. Demographic and clinical data were obtained from patients' medical records. LUTS were assessed using the structured Persian version of the International Consultation on Incontinence Questionnaire for Female LUTS (ICIQ-FLUTS) long form. RESULTS:Out of the 422 pregnant women initially enrolled, 397 met the inclusion criteria. The most prevalent bladder filling symptom was nocturia (83.9%), followed by increased frequency (52.1%) and urgency (46.9%). Voiding symptoms were less common, with interrupted stream (27.2%) and hesitancy (11.3%) being the most reported. Stress urinary incontinence was the most prevalent type of incontinence (45.1%). Multivariate logistic regression analysis showed that advancing gestational age was significantly associated with increased odds of both bladder filling (odds ratio (OR) = 1.09; p < 0.001) and urinary incontinence symptoms (OR = 1.02; p = 0.044). While higher body mass index (BMI) was associated with increased odds of urinary incontinence, the association was not statistically significant (p = 0.078). No significant predictors were found for voiding symptoms. CONCLUSION:This study highlights the high prevalence of LUTS, especially nocturia and stress urinary incontinence, among pregnant women in Yazd. Advancing gestational age and higher BMI were associated with increased symptoms, while gestational diabetes was linked to greater voiding difficulties. These findings emphasize the importance of routine screening and early intervention to minimize the impact of LUTS on maternal quality of life.

Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disorder in women of reproductive age. Crocin is known as the main component of saffron, which has antioxidant properties and has the ability to scavenge free radicals. Considering the pathophysiology of PCOS and also the anti-inflammatory and antioxidant properties of crocin in improving insulin resistance, we aimed to evaluate the efficacy of the combination of crocin and metformin compared to metformin alone in PCOS patients. This study is a prospective, double-blind randomized controlled clinical trial. Fifty patients with PCOS and hirsutism were included from Baqaipour Obstetrics and Gynecology Clinic in Yazd and randomly assigned into the two study arms of control group [metformin and placebo (n = 25)] or intervention group [metformin and crocin (n = 25)]. Patients were administered crocin 15 mg tablets once a day in combination with metformin 500 mg twice a day for 12 weeks to complete three full periods of the monthly cycle. The studied endpoints were evaluated at the beginning and end of the study. Crocin significantly improved the serum level of follicle-stimulating hormone (FSH) (P = 0.048) and Ferriman- Gallwey score (P = 0.042) at day 90. Furthermore, crocin group had a significant improvement in terms of acne severity at the end of the study (P = 0.03), so that none of the patients in the crocin group had severe acne at the end of the study. However, the comparisons between two groups were not statistically significant for other evaluated outcomes including fasting blood sugar (FBS), dihydroepiandrosterone-sulfate (DHEA-S), luteinizing hormone (LH), dermatology life quality index (DLQI), and blood pressure (BP) at the end of the study. In the present study, concurrent use of crocin along with metformin was significantly effective in ameliorating the unpleasant side effects of PCOS, including hirsutism and acne, and increasing FSH sex hormone levels in patients with PCOS. 26/08/2021, Trial Registry number: IRCT20210730052027N1.

Background: To our knowledge, there is scant research on the use of rehabilitative ultrasound imaging (RUSI) method for evaluating bladder base displacement in pregnant women. The RUSI is a non-invasive and simple method that assesses the function of pelvic floor muscles (PFM) based on the movement of the bladder base. Objectives: This study aims to assess the reliability of the RUSI for the assessment of PFM function in pregnant women during voluntary muscle contractions. Materials & Methods: In this cross-sectional study, 18 pregnant women with different gestational ages participated. The amount of bladder base displacement during PFM contraction was assessed in all women and considered an indicator of PFM function. The test re-test reliability was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman plot. The percentages of standard error of measurement (SEM%) and minimal detectable change (MDC%) were also calculated. Results: The mean amount of bladder base displacement during PFM contraction at time points 1 and 2 was 4.89±1.43 and 4.81±1.41, respectively. The ICC was 0.989 (95% CI, 0.969%, 0.996%), which indicates excellent reliability. The Bland-Altman plot showed that all the points were within the 95% limits of agreement with no considerable trend or bias. The SEM% and MDC% were 3.09% and 8.41%, respectively. Conclusion: The intra-rater reliability of the RUSI to assess PFM function in pregnant women is high, and can be useful for further studies on the PFMs in pregnant women.

Introduction : The growth of endometrial tissue beyond the uterine cavity characterizes endometriosis, a chronic inflammatory disease. IL-17A, along with other immune mediators and a myriad of immune cells including Th17 lymphocytes and macrophages, are more prevalent in the peritoneal fluid of patients with endometriosis. IL-17A facilitates the implantation of endometrial tissue in ectopic locations by inducing growth factors and inflammatory cytokines from other immune cells. This work focuses on the levels of IL-17A gene expression in tissue samples from patient and control groups, as prior research has not extensively covered the gene expression of inflammatory mediators in tissue samples. Methods : This study is both experimental and case-control in nature. Tissue samples were collected from 32 women undergoing laparoscopy at Yazd Shahid Sadoughi Hospital. The samples were divided into two groups: 16 patients with endometriosis and 16 healthy individuals. Within the patient group, there were two types of samples: eutopic and ectopic. The expression of IL-17A was assessed with RT-qPCR. Results : RT-qPCR results showed a significant difference in IL-17A gene expression between ectopic lesions and eutopic samples from endometriosis patients (P value < 0.0001). Additionally, there was a significant increase in gene expression in eutopic samples from endometriosis patients compared to control samples (P value = 0.0176). Conclusion : This study confirms the crucial involvement of inflammatory mediators like IL-17A in endometriosis through molecular findings in tissue samples, reflecting the elevated IL-17A content in the eutopic endometrium and ectopic lesions of endometriosis patients.

Gestational diabetes mellitus (GDM) is a prevalent complication during pregnancy that poses risks to both maternal and fetal health. This study aims to elucidate the intricate relationship between stress and the development of GDM, highlighting how stress-related hormonal fluctuations and behavioral changes—such as increased cortisol levels, inflammation, disrupted sleep patterns, and poor dietary choices— contribute to insulin resistance and glucose dysregulation. We examine the influence of stress on hormonal and lifestyle factors associated with GDM and evaluate interventions that manage stress-related metabolic disturbances. Elevated levels of stress hormones (like cortisol and adrenaline) and inflammatory markers (such as IL-6 and TNF-α) are linked to an increased risk of GDM due to their detrimental effects on insulin sensitivity. Our findings suggest that effective interventions, including mindfulness practices, cognitive-behavioral therapy, and regular physical activity, can reduce cortisol levels and enhance glucose regulation. This underscores the necessity of addressing both the metabolic and psychological dimensions of GDM. Current evidence supports the integration of stress-reduction strategies—such as mindfulness, cognitive-behavioral therapy, and exercise—into GDM management, as they can improve glycemic control by lowering cortisol and enhancing insulin sensitivity. Recognizing stress as a modifiable risk factor for GDM is crucial for improving maternal and fetal outcomes, emphasizing the importance of incorporating stress management into GDM prevention and treatment protocols.

Background: Endometriosis is defined as the existence of endometrial glands and stroma outside the uterine cavity. This disease is responsible for about 15% of the indications for assisted reproductive technologies (ART). Materials and Methods: This study is a retrospective cross-sectional study on 1382 women aged 18-42 who underwent ART in Yazd Reproductive Sciences Institute during 2018-2022. Women were divided into two groups: women with endometriosis (N = 173) and women with a tubal factor or unexplained infertility as the control group (N = 1209). Chemical and clinical pregnancy rates and live birth rates were compared. Results: Women with endometriosis had significantly (P < 0.001) lower retrieved oocytes (7.73 ± 5.52 vs 11.53 ± 7.46), metaphase II oocytes (6.27 ± 4.72 vs 9.37 ± 6.62), and the total number of obtained embryos (3.95 ± 3.52 vs 6.13 ± 5.02). Chemical (P = 0.001) and clinical (P = 0.028) pregnancy rates were lower in women with endometriosis, while live birth rates showed no difference between the two groups (P = 0.069). Conclusion: The findings of this study showed that endometriosis can disturb reproductive outcomes after ART.

Background: Endometriosis is a multifocal gynecologic disorder during the fertility period in women. Magnetic resonance imaging (MRI) is an important diagnostic modality for this disease and can either be used alone or along with transvaginal ultrasonography. Objective: This study aims to compare the accuracy of pelvis MRI in pelvic deep endometriosis with laparoscopic findings in women referred to Shahid Sadoughi hospital in one year. Materials and Methods: This cross-sectional study was conducted on 40 women suspicious of endometriosis who referred to Shahid Sadoughi hospital, Yazd, Iran from November 2020-2021. Based on clinical findings and history, participants were referred to the imaging center for pelvic MRI. Finally, the results of MRI and diagnostic laparoscopy were compared with pathologic findings. Results: The sensitivity and specificity of MRI for pelvic endometriosis were 94.8% and 20%, respectively. Also, the positive predictive value and negative predictive value of MRI were 90.2% and 33.3%, respectively. Conclusion: Laparoscopy is still the gold standard of endometriosis diagnosis, but MRI with susceptibility -weighted imaging sequence is the best noninvasive diagnostic method.

Background: Endometriosis characterized with existence of endometrial-like tissue outside the uterus. Fibrosis of ectopic lesions is an important feature of endometriosis. IL-4 induces fibrosis via fibroblast proliferation, collagen production and myofibroblast differentiation. Increasing of miR-21 expression promotes fibroblast activation and fibrosis expansion. The aim of study was to evaluate the expression of miR-21 and its relationship with IL-4 gene expression in endometrial ectopic and eutopic tissues of endometriosis patients. Methods and Results: Ectopic and eutopic tissue samples were taken from 20 women with endometriosis, and control samples were taken from the endometrium of 20 endometriosis-free women. The relative expression of IL-4 and miR-21 evaluated by Real Time PCR. IL-4 relative gene expression was significantly increased in ectopic tissue compared to eutopic (p = 0.025) and control tissue (p = 0.021). The relative expression of miR-21 gene in ectopic tissue was increased compared to eutopic (p = 0.850) and control tissue (p = 0.978) but these differences were not significant. Also, the correlation between IL-4 and miR-21 relative gene expression was not significant (p = 0.083). Conclusion: The increased expression of miR-21 in endometrium of women with endometriosis may upregulate the IL-4 gene expression and lead to fibrosis. Further studies may suggest miR-21 and IL-4 as candidates for diagnosis of endometriosis.

Endometriosis is a common estrogen-dependent disease that involves various cellular processes. Additionally, miRNAs play a crucial role in the development of the disease as an important component of the microenvironment. In this study, tissue specimens of eutopic and ectopic lesions of 20 women, whose endometriosis was later approved by the pathology laboratory, were biopsied through laparoscopy. As a control group, endometrial tissue specimens were collected from 20 women who underwent curettage for reasons unrelated to endometriosis. The expression levels of miR-20A and miR-145 and their target genes, TGF-β and NANOG, were measured in these samples as markers of stemness and immunomodulatory properties, respectively. The study also aimed to compare the expression levels of target genes and miRNAs in ectopic lesions regarding endometriosis recurrence post-surgery. The study revealed that the expression of TGF-β and NANOG genes was significantly upregulated in endometriotic tissues compared to the control group. There was also a notable increase in miR-20A and miR-145 expression in the endometriotic tissues compared to the control group. While there was no significant correlation between the expression of miR-20a and TGF-β, we observed a negative correlation between the expression level of miR-145 and NANOG. Additionally, the ROC curve analysis emphasized miR-14 as a potential biomarker for endometriosis over miR-20a. However, our findings on disease recurrence underscore the importance of miR-20a in the early detection of endometriosis recurrence.

Introduction: Cervicitis is the most common disease of the female reproductive system, affecting half of all women at some point in their lives. Failure to treat cervicitis can lead to salpingitis, pelvic inflammatory disease, infertility due to the fallopian tube factor, ectopic pregnancy, and pelvic pain syndrome. In this context, early diagnosis and effective treatment of cervicitis could play a pivotal role in its management. Due to the prevalence of cervicitis, its complications, available treatments, simplicity of treatment, and cost-effectiveness of rose oil products, the present study was conducted to investigate the effect of traditional Iranian rose oil on cervicitis.Methods: Eighty married women referred to a gynaecological clinic aged 17-55 years with a diagnosis of cervicitis randomly received Rose oil, 3 ml per night vaginally for 2 weeks, or routine anti-microbial care for 1 week. Twenty-four to forty-eight hours after the termination of the study, clinical symptoms of cervicitis were examined.Results: Out of 80 patients included in this study, 64 were re-evaluated. All symptoms including burning, itching, vaginal discharge, pain, bleeding and pain after intercourse, tenderness, cervical wound size, and fragility were improved in both groups with a statistically significant difference relative to the baseline.Discussion/Conclusions: The use of a vaginal formulation of rose oil diminishes the clinical symptoms of cervicitis without severe complications so it can be used as an alternative treatment in cervicitis, especially in recurring cases.

BACKGROUND:Endometriosis is a common gynecological condition with a substantial economic burden on society. It is known that both genetic and environmental factors are contributing to the phenotypic development of the disease. MicroRNAs have a vital role in the pathogenesis of endometriosis. miR-1271 and its direct target gene, GRB2 (growth factor receptor-bound protein 2), expression have been studied in gynecologic cancers, while their role in endometriosis has not been studied.OBJECTIVE:We measured miR-1271 and GRB2 gene expression in the eutopic and ectopic tissues of patients (endometrial tissues) in contrast to the control samples from healthy women.MATERIALS AND METHODS:In this study, a total of 45 samples (15 control samples, 15 eutopic samples and 15 ectopic samples) were collected. We used qRT-PCR (quantitative polymerase chain reaction) to evaluate the expression levels of the miR-1271 and GRB2 gene.RESULTS:We observed inverse expression of miR-1271 and GRB2 gene. MiR-1271 expression was significantly reduced in patients with endometriosis compared with healthy women. While there was a noticeable increase in the expression level of its target gene, GRB2, in tissues of endometriosis patients compared with normal control samples.CONCLUSION:We have shown an inverse relationship between the reduction of miR-1271 expression level and increase in the expression level of GRB2, therefore, increased GRB2 expression in endometriosis tissues can be due to decreased expression of this microRNA. Our findings suggested that miR-1271 maybe play a role as a biomarker in the diagnosis of patients with endometriosis.

Background: Intrauterine growth restriction ( IUGR) refers to fetuses with an estimated ultrasonography weight below the 10% percentile. Hypoglycemia is a major concern in neonates with IUGR. Objective: To investigate the relationship between umbilical artery (UA) Doppler ultrasonography and neonate hypoglycemia and IUGR. Materials and Methods: This was a longitudinal follow-up study consisting of 114 neonates (gestational age of 28-40 wk) born with IUGR in the third trimester of pregnancy at Shahid Sadoughi Hospital, Yazd, Iran between May 2016 and October 2017. The neonates were assigned into three subgroups of normal UA Doppler, absent end-diastolic flow (EDF) in UA Doppler, and reverse EDF in UA Doppler. The blood glucose of the neonates was checked one, two, three, six, 12, 24 and 48 hr after birth, and the neonates were placed in the hypoglycemia or euglycemia groups according to guidelines. Results: Out of the 114 neonates included in the study, 75 (65.8%) had normal UA Doppler, 29 (25.4%) had absent EDF in UA Doppler, and 10 (8.8%) had reverse EDF in UA Doppler. There was a significant difference in the mean blood glucose in the first hr between the normal UA Doppler group and the reverse EDF in UA Doppler group (p < 0.01). Conclusion: Postnatal hypoglycemia in neonates with IUGR is associated with the result of UA Doppler ultrasonography during pregnancy.

Background: Most pregnant women with COVID-19 develop less severe form of the disease, with few cases of severe maternal morbidity and mortality, or perinatal deaths. This meta-analysis was conducted to evaluate the frequency of miscarriage in pregnant women affected by the SARS-COV-2 infection. Methods: A comprehensive search was performed in online databases to identify all relevant studies published up to 5th March 2021. Case-control studies and case series reported the frequency of miscarriage in pregnant women with COVID-19 was selected. Results: A total of 22 studies with 8591 infected pregnant women and 141 abortions were selected. The frequency of miscarriage was 3.9% (95% CI 0.023-0.063) in infected pregnant women with COVID-19. It had the highest frequency in Asian (6.3%) followed by European (2.9%), West-Asian (2.5%) and Caucasian (2.3%) infected pregnant women. Moreover, stratified analysis by country showed that the frequency of miscarriage is the highest in Chinese (11.3%) followed by Italy (11.2%), India (2.7%), Turkey (2.2%), USA (1.2%) and France (0.9%) infected pregnant women. Conclusion: Our pooled data revealed that the frequencies of miscarriage in pregnant women with SARS-COV-2 infection were 3.9%.

BACKGROUND:Endometriosis is a chronic and relatively common disease in women of childbearing age. Complications of this disease include a wide range of disorders. The cause of this disease is not known for sure, but several hypotheses have been proposed for it.AIM:In this review, an attempt has been made to discuss the effects of oxidative stress on various complications of endometriosis.CONTENT:In endometriosis, the entry of endometrial tissues into the peritoneal cavity causes oxidative stress through the Fenton reaction and inflammation in this site. Fenton reaction can produce reactive oxygen species through a catalytic form of iron. This process can provoke inflammatory responses and oxidative injury. As a result, the activity of macrophages and expression of nuclear factor-kappa B increase. Oxidative stress can be associated with many complications of endometriosis. It has been reported that in the peritoneal fluid of endometriosis patients, there are activated macrophages, growth factors, and high concentrations of cytokines. These conditions act as a toxic to embryo survival and sperm function.IMPLICATIONS:Novel therapeutic strategies must regulate intracellular ROS signaling to inhibit the adverse effects of ROS-induced endometriosis-promoting events. According to features of antioxidants, they may inhibit early events of the development of endometriosis.

Background: Endometriosis, a prevalent multifactorial condition, has a different effect on mental and physical health in women. MicroRNAs have been reported as a main epigenetic factor in endometriosis pathogenesis. However, the role of miR-337-3p and its direct target gene, RAP1A, in endometriosis tissues have not been investigated. Objective: The aim of this study was to evaluate the expression level of miR-337-3p and RAP1A gene in endometriosis tissues and normal endometrium tissues. Materials and methods: We measured the expression levels of miR-337-3p and RAP1A gene by quantitative polymerase chain reaction (qRT-PCR) in 15 eutopic and ectopic tissue samples of superficial peritoneal lesions from women with endometriosis and 15 normal endometrial tissue samples from women without any symptom of endometriosis. Results: The results showed the expression level of RAP1A gene significantly increased in endometriosis tissue samples (both of ectopic and eutopic tissues), while miR-337-3p expression level decreased significantly in these tissues compared to the normal endometrium. Conclusion: In this study, we observed an inverse relationship between miR-337-3p and RAP1A gene expression in endometriosis. Dysregulation of these genes can also be interpreted as their role in the pathogenesis and progression of endometriosis.

Background: Gestational diabetes mellitus (GDM) is a complex metabolic disorder of pregnancy with a strong genetic predisposition. GDM is associated with complications during pregnancy and increased risk of type 2 diabetes later in mothers and develops a vicious cycle of metabolic diseases for future generations. Evidence is accumulating that women with genetic variants at transcription factor 7-like 2 (TCF7L2) gene are more susceptible to GDM. The aim of the current meta-analysis was to assess the association of the TCF7L2 polymorphisms with GDM risk. Methods: PubMed, Web of Science, Embase, SID and CNKI databases were searched to identify relevant studies up to November 01, 2020. Using the fixed-effect or random-effect model, the pooled odds ratio and its corresponding 95% confidence interval were computed. Results: A total of 38 case-control studies including 24 studies with 6021 cases and 13289 controls on rs7903146, eight studies with 2404 cases and 2615 controls on rs12255372 and six studies with 1357 cases and 2858 controls on rs7901695 polymorphism were selected. Pooled data showed that there was a significant association between the TCF7L2 rs7903146, rs12255372 and rs7901695 polymorphisms and an increased risk of GDM in whole population. Stratified analysis showed that the TCF7L2 rs7903146 polymorphism was associated with GDM in Caucasian, mixed and Chinese women, but not in Asians. Moreover, the TCF7L2 rs12255372 polymorphism was associated with GDM in Asians and Caucasians women with GDM. Conclusion: The combined data indicated that the TCF7L2 rs7903146, rs12255372 and rs7901695 polymorphisms were associated with a significant risk of GDM in whole population, especially in Caucasian women.