The Effectiveness of Metformin in Reducing the Risk of Preeclampsia in Patients with Polycystic Ovary Syndrome (PCOS) : A Systematic Review
Abstract
Introduction: Polycystic Ovary Syndrome (PCOS) affects a significant proportion of women of reproductive age and is associated with an elevated risk of adverse pregnancy outcomes, including preeclampsia (PE). Metformin, an insulin sensitizer, has been proposed as a potential intervention to reduce this risk. However, the evidence regarding its effectiveness in preventing PE specifically in pregnant women with PCOS remains inconsistent.
Methods: This study conducted a systematic synthesis of evidence from 41 sources, including major randomized controlled trials (RCTs) etc. The primary outcome was the incidence of preeclampsia. Secondary outcomes included early pregnancy loss, preterm delivery, gestational diabetes mellitus (GDM), and gestational weight gain. A methodological quality assessment was performed, distinguishing between evidence from RCTs and non-randomized studies.
Results: The findings were discordant. Non-randomized studies reported a significant reduction in PE risk with metformin (e.g., Zheng et al., 2013: OR 0.53; Zhao & He, 2022: RR 0.61). However, analyses restricted to high-quality RCTs found no significant benefit. In the PregMet trial (Vanky et al., 2010), PE rates were 7.4% in the metformin group vs. 3.7% in the placebo group (p=0.18). The PregMet2 trial (Løvvik et al., 2019) also found no significant reduction. A meta-analysis of PCOS-specific RCTs (Nascimento et al., 2018) produced a pooled RR of 1.96 (0.81–4.77), trending toward harm. Conversely,…
How strong is the evidence?
Evidence Hub reads this as a systematic review, 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.
Read the paper
Related studies
- Increased expression of circulating miRNA-93 in women with polycystic ovary syndrome may represent a novel, non-invasive biomarker for diagnosis
- Identification of key genes associated with polycystic ovary syndrome (PCOS) and ovarian cancer using an integrated bioinformatics analysis
- Identification of key pathways and genes in polycystic ovary syndrome via integrated bioinformatics analysis and prediction of small therapeutic molecules
- Regulation of Androgen Receptor Expression Alters AMPK Phosphorylation in the Endometrium: In Vivo and In Vitro Studies in Women with Polycystic Ovary Syndrome
- Effect of oral administration of low-dose follicle stimulating hormone on hyperandrogenized mice as a model of polycystic ovary syndrome
- Systems pharmacology to investigate the interaction of berberine and other drugs in treating polycystic ovary syndrome
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.