28 Mar Metformin in Pregnancy Associated With Increased Obesity in Children
MedicalResearch.com Interview with:
Liv Guro Engen Hanem, PhD Candidate
Department of Clinical and Molecular Medicine
Norwegian University of Science and Technology
MedicalResearch.com: What is the background for this study?
Response: The antidiabetic drug metformin is increasingly used in pregnancy: to treat gestational diabetes and type 2 diabetes, and to prevent pregnancy complications related to polycystic ovary syndrome (PCOS) and obesity. Metformin passes the placenta, and the fetus is thus exposed to the drug. Although no teratogenicity has been reported, metformin might have long-term effects on offspring health.
This study is a follow-up of cardiometabolic risk factors of 141 5- to 10-year-old children born in the PregMet study. This study was a double-blind, randomized controlled trial (RCT) designed to test the hypothesis that metformin given throughout pregnancy reduces the prevalence of pregnancy complications that are associated with the common endocrine disorder PCOS. Pregnant women with PCOS were randomized to receive metformin or placebo throughout pregnancy.
MedicalResearch.com: What are the main findings?
Response: We found that children exposed to metformin in pregnancy had higher BMI than those exposed to placebo. They also had higher measures of central adiposity, and higher prevalence of obesity.
MedicalResearch.com: What should readers take away from your report?
Response: Metformin in pregnancy was associated with higher measures of general and central adiposity. At this age, this tend to track into adulthood, and increase the risk of premature mortality and morbidity. These results cannot exclude implications for future health, and endorse cautious use of metformin in pregnancy.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our findings need to be confirmed and their implications for future health should be studied further. We suggest that all intervention studies with metformin in pregnancy should follow-up the long-term health of the offspring.
MedicalResearch.com: Is there anything else you would like to add?
Response: Our research group recently published an individual patient data pooled analysis of 789 participants in three RCTs comparing metformin to placebo in PCOS pregnancies. In this analysis we found a significant reduction of the prevalence of late miscarriage and premature births1. The consideration of metformin treatment in PCOS pregnancies should include individual patient risk, and the beneficial effects of metformin for pregnancy outcome should be weighed against potential effects on offspring health.
The authors have nothing to disclose
Intrauterine metformin exposure and offspring cardiometabolic risk factors (PedMet study): a 5–10 year follow-up of the PregMet randomised controlled trial
Liv Guro Engen Hanem, MD, Øyvind Salvesen, PhD, Prof Petur B Juliusson, MD, Prof Sven M Carlsen, MD, Marit Cecilie Fonn Nossum, MD
Marte Øye Vaage, MD, Rønnaug Ødegård, PhD, Prof Eszter Vanky, MD
January 28, 2019DOI:https://doi.org/10.1016/S2352-4642(18)30385-7
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