Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis
Abstract
Abstract Objective: We systematically assessed the impact of metformin treatment on maternal pregnancy outcomes. Data Sources: PubMed, Ovid Embase, Medline, Web of Science, ClinicalTrials.gov and Cochrane databases were systematically searched (inception-19th November 2020). Methods of Study Selection: Randomized controlled trials reporting pregnancy outcomes in women randomized to metformin versus any other treatment for any indication were included. Outcomes included gestational weight gain (GWG), pre-eclampsia, pregnancy-induced hypertension, preterm birth, gestational age at delivery, cesarean section, gestational diabetes, glycemic 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. Tabulation, integration and results: Thirty-five studies (n=8033 pregnancies) met eligibility criteria. GWG was lower in pregnancies randomized to metformin versus other treatments (1.57kg±0.60kg; I2=86%, p<0.0001), as was likelihood of pre-eclampsia (OR 0.65, 95%CI:0.47-0.91; I2=52%, p=0.01). 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. Conclusions: Metformin for any…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 8,033 participants or records.
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