Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis

Abstract We systematically assessed the impact of metformin treatment on maternal pregnancy outcomes. PubMed, Ovid Embase, Medline, Web of Science, ClinicalTrials.gov and Cochrane databases were systematically searched (inception-1st February 2021). Randomised controlled trials reporting pregnancy o...

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Autores principales:	Jane L. Tarry-Adkins, Susan E. Ozanne, Catherine E. Aiken
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4d1d8a695c374a179146bc31d45198f1
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spelling	oai:doaj.org-article:4d1d8a695c374a179146bc31d45198f12021-12-02T17:15:33ZImpact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis10.1038/s41598-021-88650-52045-2322https://doaj.org/article/4d1d8a695c374a179146bc31d45198f12021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88650-5https://doaj.org/toc/2045-2322Abstract We systematically assessed the impact of metformin treatment on maternal pregnancy outcomes. PubMed, Ovid Embase, Medline, Web of Science, ClinicalTrials.gov and Cochrane databases were systematically searched (inception-1st February 2021). Randomised controlled trials reporting pregnancy outcomes in women randomised to metformin versus any other treatment for any indication were included. Outcomes included gestational weight gain (GWG), pre-eclampsia, gestational hypertension, preterm birth, gestational age at delivery, caesarean section, gestational diabetes, glycaemic control, and gastrointestinal side-effects. Two independent reviewers conducted screening, with a third available to evaluate disagreements. Risk-of-bias and GRADE assessments were conducted using Cochrane Risk-of-Bias and GRADE-pro software. Thirty-five studies (n = 8033 pregnancies) met eligibility criteria. GWG was lower in pregnancies randomised to metformin versus other treatments (1.57 kg ± 0.60 kg; I2 = 86%, p < 0.0001), as was likelihood of pre-eclampsia (OR 0.69, 95% CI 0.50–0.95; I2 = 55%, p = 0.02). The risk of gastrointestinal side-effects was greater in metformin-exposed versus other treatment groups (OR 2.43, 95% CI 1.53–3.84; I2 = 76%, p = 0.0002). The risk of other maternal outcomes assessed was not significantly different between metformin-exposed versus other treatment groups. Metformin for any indication during pregnancy is associated with lower GWG and a modest reduced risk of pre-eclampsia, but increased gastrointestinal side-effects compared to other treatments.Jane L. Tarry-AdkinsSusan E. OzanneCatherine E. AikenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jane L. Tarry-Adkins Susan E. Ozanne Catherine E. Aiken Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis
description	Abstract We systematically assessed the impact of metformin treatment on maternal pregnancy outcomes. PubMed, Ovid Embase, Medline, Web of Science, ClinicalTrials.gov and Cochrane databases were systematically searched (inception-1st February 2021). Randomised controlled trials reporting pregnancy outcomes in women randomised to metformin versus any other treatment for any indication were included. Outcomes included gestational weight gain (GWG), pre-eclampsia, gestational hypertension, preterm birth, gestational age at delivery, caesarean section, gestational diabetes, glycaemic control, and gastrointestinal side-effects. Two independent reviewers conducted screening, with a third available to evaluate disagreements. Risk-of-bias and GRADE assessments were conducted using Cochrane Risk-of-Bias and GRADE-pro software. Thirty-five studies (n = 8033 pregnancies) met eligibility criteria. GWG was lower in pregnancies randomised to metformin versus other treatments (1.57 kg ± 0.60 kg; I2 = 86%, p < 0.0001), as was likelihood of pre-eclampsia (OR 0.69, 95% CI 0.50–0.95; I2 = 55%, p = 0.02). The risk of gastrointestinal side-effects was greater in metformin-exposed versus other treatment groups (OR 2.43, 95% CI 1.53–3.84; I2 = 76%, p = 0.0002). The risk of other maternal outcomes assessed was not significantly different between metformin-exposed versus other treatment groups. Metformin for any indication during pregnancy is associated with lower GWG and a modest reduced risk of pre-eclampsia, but increased gastrointestinal side-effects compared to other treatments.
format	article
author	Jane L. Tarry-Adkins Susan E. Ozanne Catherine E. Aiken
author_facet	Jane L. Tarry-Adkins Susan E. Ozanne Catherine E. Aiken
author_sort	Jane L. Tarry-Adkins
title	Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis
title_short	Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis
title_full	Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis
title_fullStr	Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis
title_full_unstemmed	Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis
title_sort	impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4d1d8a695c374a179146bc31d45198f1
work_keys_str_mv	AT janeltarryadkins impactofmetformintreatmentduringpregnancyonmaternaloutcomesasystematicreviewmetaanalysis AT susaneozanne impactofmetformintreatmentduringpregnancyonmaternaloutcomesasystematicreviewmetaanalysis AT catherineeaiken impactofmetformintreatmentduringpregnancyonmaternaloutcomesasystematicreviewmetaanalysis
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Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis

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