Placental and cerebral circulation in fetuses of mothers with polycystic ovary syndrome and the effect of Metformin exposure
Abstract
BACKGROUND: Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy complications and fetal growth restriction is reported. Increased head size has been reported in PCOS-offspring exposed to intrauterine metformin. We aimed to explore whether maternal PCOS-status, and the use of metformin, during pregnancy affect fetal cerebral and placental circulation.
METHODS: The Pilot (2000-2003) and the PregMet2 (2012-2017) studies are randomized controlled trials where women with PCOS were randomized to metformin or placebo in pregnancy. Individually pooled data from Doppler examinations at gestational week 32 from these RCT's were included in a post-hoc analysis of totally 64 participants. The pulsatility index (PI) z-scores of the fetal middle cerebral artery (MCA), umbilical artery (UmbA), and the cerebroplacental ratio (CPR) were compared between the metformin and placebo treated groups with a two-sample t-test. The PI z-scores of the women with PCOS were compared to low-risk reference populations of pregnant women. The PI z-scores were correlated with maternal BMI at inclusion, androgen levels measured at gestational week 32, percentage gestational weight gain from first trimester to gestational week 32 and offspring head circumference.
RESULTS: There was no significant difference in PI z-scores of fetal MCA, UmbA, and CPR between metformin and placebo treated women with PCOS, or between women with PCOS compared to low-risk reference populations. Maternal…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 64 participants or records.
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