Metformin use in gestational diabetes: Efficacy and maternal and neonatal outcomes

Moore, Lisa E.; Clokey, Diana; Briery, Christian; Morrison, John C.

doi:10.1016/j.ajog.2006.10.498

Cited by 4 publications

(5 citation statements)

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“…With regard to the Apgar score in the current study, the majority of the neonates were born with an Apgar score ≥7. Various other studies have also indicated no significant differences between the two treatment groups concerning the Apgar score (Mesdaghinia et al, ; Moore et al, ; Tertti et al, ).…”

Section: Discussionmentioning

confidence: 83%

“…Likewise, a randomized controlled trial conducted in 2016 revealed no statistically significant differences between the metformin and insulin groups in terms of the number of cesarean section cases (Saleh et al, ). Also, the study of Moor et al () on 32 patients in the metformin group and 31 subjects in the insulin group reported no statistically significant difference between the two groups in regard incidence of cesarean section.…”

Section: Discussionmentioning

confidence: 89%

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The efficacy of metformin compared with insulin in regulating blood glucose levels during gestational diabetes mellitus: A randomized clinical trial

Ghomian

Vahed

Firouz

et al. 2018

Journal Cellular Physiology

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 89%

The efficacy of metformin compared with insulin in regulating blood glucose levels during gestational diabetes mellitus: A randomized clinical trial

Ghomian

Vahed

Firouz

et al. 2018

Journal Cellular Physiology

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“…[3] . To date, no significant adverse effect has been reported associated with the normal usage of metformin during pregnancy, nor have adverse effects been reported in babies delivered from mothers who regularly use prescribed metformin [4,6] . It is clear that this patient developed lactic acidosis due to metformin overdose during pregnancy, without any other comorbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Metformin can pass freely through the placenta; however, normal doses of metformin in gestational diabetes is not reported to be associated with fetal abnormalities [6] . In this case, the fetal condition remained normal during the hospital stay and there were no adverse effects from the toxicological and metabolic insult during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Metformin-Associated Lactic Acidosis in a Pregnant Patient

Hong

O’Boyle²,

Chen

et al. 2008

Gynecol Obstet Invest

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Metformin-associated lactic acidosis is a rare but serious condition and potentially even more hazardous during pregnancy. We reported a case of lactic acidosis in a 28-year-old pregnant woman (gravida 3, para 0, abortion 2, ante-partum 22 weeks) after ingestion of 39.50 g (approximately 80 tablets) metformin in a suicide attempt. She had no pre-existing systemic illness. Analysis of arterial blood gases revealed a high anion gap (28.1 mEq/l) and a normal osmol gap (8 mEq/l) metabolic acidosis. Other etiologies of high anion gap and normal osmol gap metabolic acidosis were excluded by laboratory investigation. The patient was treated on an emergency basis and received aggressive fluid management, intravenous sodium bicarbonate (1 mEq/kg) and activated charcoal, orally. The fetal condition was monitored intensively. The fetus was delivered smoothly via vaginal delivery in a healthy state at the 38th gestational week. Clinical follow-up over the next 2 years confirmed no congenital abnormality. We present a case of successful management of metformin-associated lactic acidosis during pregnancy, treated simply, with intravenous sodium bicarbonate and intensive fetal monitoring. This relatively noninvasive method is an effective treatment option. However, hemodialysis still has a valuable role in the management of acidosis which proves refractory to conservative treatment, such as that described.

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“…One of the first studies to compare safety and efficacy of metformin vs. insulin in 63 women with gestational diabetes and similar baseline characteristics was published in 2007 by Moore et al (17). Preliminary data showed no statistically significant difference in the rate of cesarean delivery (p = 0.102) and of neonatal characteristics at birth [birth weight, neonatal hypoglycemia, respiratory distress syndrome, hyperbilirubinemia, Apgar score at 5 min, and neonatal intensive care unit (NICU) admission (p = 0.144-0.373)].…”

Section: Metformin and Gestational Diabetesmentioning

confidence: 99%

Lights and shadows on the use of metformin in pregnancy: from the preconception phase to breastfeeding and beyond

et al. 2023

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During pregnancy, the complex hormonal changes lead to a progressive decrease of insulin sensitivity that can drive the onset of gestational diabetes (GDM) or worsen an already-known condition of insulin resistance like type 2 diabetes, polycystic ovarian syndrome (PCOS), and obesity, with complications for the mother and the fetus. Metformin during pregnancy is proving to be safe in a growing number of studies, although it freely crosses the placenta, leading to a fetal level similar to maternal concentration. The aim of this literature review is to analyze the main available evidence on the use of metformin during, throughout, and beyond pregnancy, including fertilization, lactation, and medium-term effects on offspring. Analyzed studies support the safety and efficacy of metformin during pregnancy. In pregnant women with GDM and type 2 diabetes, metformin improves obstetric and perinatal outcomes. There is no evidence that it prevents GDM in women with pregestational insulin resistance or improves lipid profile and risk of GDM in pregnant women with PCOS or obesity. Metformin could have a role in reducing the risk of preeclampsia in pregnant women with severe obesity, the risk of late miscarriages and preterm delivery in women with PCOS, and the risk of ovarian hyperstimulation syndrome, increasing the clinical pregnancy rate in women with PCOS undergoing in vitro fertilization (IVF/FIVET). Offspring of mothers with GDM exposed to metformin have no significant differences in body composition compared with insulin treatment, while it appears to be protective for metabolic and cardiovascular risk.

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Metformin use in gestational diabetes: Efficacy and maternal and neonatal outcomes

Cited by 4 publications

References 0 publications

The efficacy of metformin compared with insulin in regulating blood glucose levels during gestational diabetes mellitus: A randomized clinical trial

The efficacy of metformin compared with insulin in regulating blood glucose levels during gestational diabetes mellitus: A randomized clinical trial

Metformin-Associated Lactic Acidosis in a Pregnant Patient

Lights and shadows on the use of metformin in pregnancy: from the preconception phase to breastfeeding and beyond

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