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Efficacy and safety of metformin during pregnancy in women with gestational diabetes mellitus or polycystic ovary syndrome: A systematic review
Abstract
Background Metformin is an effective oral anti-hyperglycemic agent that is widely used to manage diabetes mellitus type 2 in the general population and more recently, in pregnancy. However, as metformin crosses the placenta, its use during pregnancy raises concerns regarding potential adverse effects on the mother and fetus.Objective (i) To provide background for the use of metformin during pregnancy through a narrative review and (ii) to critically appraise the published evidence on the efficacy and safety of using metformin during pregnancy through a systematic review.Results Metformin appears to be effective and safe for the treatment of gestational diabetes mellitus (GDM), particularly for overweight or obese women. However, patients with multiple risk factors for insulin resistance may not meet their treatment goals with metformin alone and may require supplementary insulin. Evidence suggests that there are potential advantages for the use of metformin over insulin in GDM with respect to maternal weight gain and neonatal outcomes. Furthermore, patients are more accepting of metformin than insulin. The use of metformin throughout pregnancy in women with polycystic ovary syndrome reduces the rates of early pregnancy loss and preterm labor and protects against fetal growth restriction. There have been no demonstrable teratogenic effects, intra-uterine deaths or developmental delays with the use of metformin.Conclusions The publications reviewed in this paper support the efficacy and safety of metformin during pregnancy with respect to immediate pregnancy outcomes. Because there are no guidelines for the continuous use of metformin in pregnancy, the duration of treatment is based on clinical judgment and experience on a case-by-case basis.
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“In addition, rare side-effects such as mild erythema and decreased vitamin B12 absorption have been associated with long-term administration(252).”
From Metformin, the Aspirin of the 21st Century: Its Role in Gestational Diabetes Mellitus, Prevention of Preeclampsia and Cancer, and the Promotion of Longevity (2017) · cites this paper as [252]
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Oyenihi, A. B. (2016) · ResearchSpace (University of KwaZulu-Natal)
Treatment of Gestational Diabetes
Maged, A. M. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.86988
Metadata
- Authors
- Lautatzis, M.-E., Goulis, D. G., & Vrontakis, M.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- University of Manitoba (CA)
- Corresponding author
- Lautatzis, Maria-Elena
- Venue
- Metabolism
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 62
- Issue
- 11
- Pages
- 1522-1534
- ISSN
- 0026-0495 (ISSN-L)
- OpenAlex
- W1979876574
- Cited by
- 113
- References
- 77
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 9 · 2022: 4 · 2021: 8 · 2020: 8 · 2019: 9 · 2018: 13 · 2017: 9 · 2016: 14 · 2015: 14 · 2014: 18 · 2013: 2
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- metformin, pregnancy, gestational diabetes mellitus, polycystic ovary syndrome, drug safety, teratogenicity, fetal growth restriction, preterm labor, miscarriage, gestational weight gain, neonatal outcomes, insulin resistance, insulin therapy comparison, maternal-fetal drug transfer
- MeSH terms
- Adult, Clinical Trials as Topic, Female, Humans, Hypoglycemic Agents, Insulin, Insulin Resistance, Metformin, Obesity, Polycystic Ovary Syndrome, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Diabetes, Gestational, Treatment Outcome
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