Effect of metformin treatment during pregnancy on women with PCOS: a systematic review and meta-analysis
Open accessAbstract
Purpose: Some previous studies have found that continued metformin use is beneficial in the management of polycystic ovary syndrome (PCOS) in pregnant women. A systemic review and meta-analysis were needed to more fully assess the effects of metformin on pregnant PCOS patients. Methods: The literature was fully searched using MEDLINE, EMBASE, SCOPUS, and COCHRANE for continued metformin use during pregnancy in women with PCOS. A systematic review and meta-analysis were performed to evaluate the comprehensive effects of continued metformin treatment on pregnancy-related outcomes in these women. Results: Eleven eligible studies out of 127 relevant publications were included in meta-analysis. The rates of early pregnancy loss and preterm delivery were found to be significantly decreased in metformin-treated PCOS women. A non-significant difference was found in fetal abnormality and fetal birth weight between the metformin-treated and the non-treated groups. The incidence of gestational diabetes mellitus (GDM) and hypertension/preeclampsia were not significantly different in the two groups, probably because of inconsistent results in the subgroup analysis. Conclusions: Our results showed that continued use during of metformin, during pregnancy in women with PCOS, had no effect on incidence of fetal abnormalities or fetal birth weight. The effects of metformin on GDM and hypertension/preeclampsia should be determined through high-quality randomized controlled trials.
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Evidence regarding the impact of metformin on the incidence of gestational diabetes mellitus is controversial.
“Evidence regarding the impact of metformin on the incidence of GDM is controversial [58–61].”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [59]
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References 46 · Cited by 51
Research works printed but not linked: 7
- Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group 2004 Revised: Consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2003; 81: 19-25.
- Dunaif A, Graf M, Mandeli J, Laumas V, Dobrjansky A: Characterization of groups of hyperandrogenic women with acanthosis nigricans, impaired glucose tolerance, and/or hyperinsulinemia. J Clin Endocrinol Metab 1987; 65: 499- 4507.
- Johnson N: Metformin is a reasonable first-line treatment option for non-obese women with infertility related to anovulatory polycystic ovary syndrome-A meta-analysis of randomized trails. Aust N Z J Obstet Gynaecol 2011; 51: 125-129.
- Nawaz FH, Khalid R, Naru T, Rizvi J: Does continuous use of metformin throughout pregnancy improves pregnancy outcomes in women with polycystic ovarian syndrome? J Obstet Gynaecol Res 2008; 34: 832-837.
- Practice Committee of the American Society for Reproductive Medicine: Use of insulin sensitizing agents in the treatment of polycystic ovary syndrome. Fertil Steril 2004; 82: S181-S183.
- Lord JM, Flight IH, Norman RJ: Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ 2003; 327: 951-953.
- Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, Steinkampf MP, Coutifaris C, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Giudice LC, Leppert PC, Myers ER; Cooperative Multicenter Reproductive Medicine Network: Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med 2007; 356: 551-566.
- Authors
- Tan, X., Li, S., Chang, Y., Fang, C., Liu, H., Zhang, X., & Wang, Y.
- Affiliations
- Department of Endocrinology, 9th People’s Hospital of Chongqing, 400700 Chongqong, China
- Second Affiliated Hospital of Chongqing Medical University (CN)
- Third People 's Hospital of Chongqing (CN)
- University of Mississippi Medical Center (US)
- Venue
- Clinical and Investigative Medicine
- Published
- 2016-09-11
- Volume
- 39
- Issue
- 4
- Pages
- E120-E131
- ISSN
- 0147-958X (ISSN-L)
- 1488-2353
- OpenAlex
- W2528006260
- Cited by
- 51
- References
- 46
- Citations by year
- 2025: 7 · 2024: 3 · 2023: 4 · 2022: 10 · 2021: 10 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 1
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical and investigative medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Keywords
- metformin, polycystic ovary syndrome, pregnancy, pregnancy outcomes, early pregnancy loss, preterm birth, fetal malformations, birth weight, gestational diabetes mellitus, preeclampsia, hypertension in pregnancy
- MeSH terms
- Abortion, Spontaneous, Birth Weight, Female, Humans, Hypertension, Hypoglycemic Agents, Metformin, Polycystic Ovary Syndrome, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Diabetes, Gestational, Evidence-Based Medicine, Premature Birth
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