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Pregnancy in women with Type 2 diabetes: who takes metformin and what is the outcome?
Author(s) -
Hughes R. C. E.,
Rowan J. A.
Publication year - 2006
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2006.01750.x
Subject(s) - medicine , metformin , pregnancy , preeclampsia , obstetrics , body mass index , type 2 diabetes , diabetes mellitus , respiratory distress , gynecology , endocrinology , surgery , genetics , biology
Aims To review pregnancy outcomes in women with Type 2 diabetes (Type 2 DM), comparing women treated with those not treated with metformin. Methods Data were collected by case‐note review for all pregnancies in women with Type 2 DM over a 6‐year period (1998–2003) at the National Women's Hospital. Two hundred and fourteen pregnancies were included, metformin was taken in 93 pregnancies and continued until delivery in 32; the remaining 121 pregnancies comprised the control group. The principal outcome measures were preeclampsia, perinatal loss and neonatal morbidity. Results Baseline characteristics differed between groups: women in the metformin group had greater mean ( sd ) body mass index [35.5(7.6) vs. 33.5(6.6) kg/m 2 , P < 0.05], more chronic hypertension (19% vs. 7%, P < 0.05) and higher mean ( sd ) first trimester glycated haemoglobin (HbA 1c ) levels [8.3(1.9)% vs. 7.5(1.7)%, P < 0.005]. There was no difference between metformin and control groups, respectively, in the rate of preeclampsia (13% vs. 14%, P = 0.84), perinatal loss (3% vs. 2%, P = 0.65) or neonatal morbidity, including rate of prematurity (23% vs. 22%, P = 0.7), admission to the neonatal unit (40% vs. 48%, P = 0.27), respiratory distress (9% vs. 18%, P = 0.07) and treatment with intravenous dextrose (20% vs. 31%, P = 0.08). Conclusions Pregnant women with Type 2 DM who were treated with metformin had more risk factors for adverse pregnancy outcomes, but no differences in outcomes were seen compared with women not taking metformin. We need randomized trials to address potential benefits of metformin treatment in this population that may be masked by current practice.