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Questions over metformin use in obese pregnant women

By Colin Kenny, Editor – Diabetes Distilled

Australian investigators wanted to examine appropriate antenatal dietary and lifestyle advice for women who were obese or overweight during pregnancy in order to limit gestational weight gain and improve maternal and infant health. They performed a Cochrane database search for studies using metformin as an adjuvant therapy to current antenatal strategies in pregnant women with obesity. They found insufficient evidence to support metformin use in obese women during pregnancy to improve maternal and infant outcomes. However, there was an increased risk of adverse effects, particularly diarrhoea, in pregnant women taking metformin.

This study used a Cochrane Collaboration methodology to evaluate whether metformin use in pregnant women with obesity, but not diabetes, had a beneficial impact on maternal and infant outcomes. The adverse effects of treatment and costs were also examined. Researchers recognised that babies born to women who are obese are more likely to experience health problems. They found three randomised controlled studies (including a total of 1,099 pregnant women) comparing metformin tablets with placebo from 10 to 20 weeks of pregnancy until birth. 
Little evidence was found that taking metformin reduced the chances of pregnant women with obesity developing gestational hypertension, preeclampsia or gestational diabetes, or having a large-for-gestational-age baby. Metformin was, however, associated with an increased risk of adverse effects, particularly diarrhoea. A small number of studies were included in this review and none of the studies assessed metformin in combination with another treatment. The researchers concluded that more research is needed to evaluate the role of metformin in pregnant women who are overweight or obese as a strategy for improving maternal and infant health outcomes.

To access the publication, click here

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