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Metformin use in pregnancy not associated with congenital anomalies

By Colin Kenny, Editor – Diabetes Distilled

Investigators wanted to find out whether exposure to metformin during the first trimester of pregnancy, for diabetes or other indications, increased the risk of congenital anomalies. They examined a European congenital anomaly registry (EUROmediCAT). They found 168 babies affected by a congenital anomaly (141 non-genetic and 27 genetic) who were exposed to metformin. No evidence was found for a significantly increased risk of all non-genetic congenital anomalies following exposure to metformin during the first trimester.  

Metformin has been recommended for use in pregnancy in the UK since 2008 in women with gestational diabetes and with type 2 diabetes, which is increasing sharply in prevalence. They used the EUROmediCAT, a population-based reproductive pharmacovigilance system based on the European Surveillance of Congenital Anomalies (EUROCAT) network, to find a cohort of patients exposed to metformin. They estimated that approximately 6,245 pregnancies in the surveyed population were exposed to metformin.
Twenty-nine subgroups of congenital anomaly had three or more metformin-exposed cases. Metformin exposure was more common among older mothers, multiple pregnancies and preterm births.They found no evidence of an overall increased risk of all major congenital anomalies combined after exposure to metformin during the first trimester. They felt that, given the rise in exposure to metformin during pregnancy, these findings were reassuring.

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