Effect of metformin on maternal and neonatal outcomes in pregnant obese non-diabetic women: A meta-analysis
| Autor: | Magdy I. Mostafa, Omar Elshahat, Amany Emara, Abdelrahman Ibrahim Abushouk, Hussien Ahmed, Ahmed Elmaraezy |
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| Předmět: |
medicine.medical_specialty
lcsh:QH471-489 Birth weight lcsh:Gynecology and obstetrics Preeclampsia Miscarriage 03 medical and health sciences Diabetes mellitus 0302 clinical medicine Pregnancy medicine lcsh:Reproduction Obesity 030212 general & internal medicine lcsh:RG1-991 030219 obstetrics & reproductive medicine business.industry Obstetrics Meta Analysis Obstetrics and Gynecology medicine.disease Metformin Gestational diabetes Reproductive Medicine medicine.symptom business Weight gain medicine.drug |
| Zdroj: | Scopus-Elsevier International Journal of Reproductive BioMedicine, Vol 15, Iss 8, Pp 461-470 (2017) International Journal of Reproductive Biomedicine Europe PubMed Central |
| Popis: | Background: Metformin reduces maternal and neonatal weight gain in gestational diabetes mellitus; however, this effect is poorly investigated in non-diabetic women. Objective: We performed this meta-analysis to investigate the effect of metformin intake during pregnancy on maternal and neonatal outcomes in obese non-diabetic women. Materials and Methods: We searched Medline, EMBASE, and Cochrane CENTRAL for eligible randomized controlled trials addressing the efficacy of metformin in pregnant obese non-diabetic women. Data were extracted and analyzed using RevMan software (Version 5.3). Neonatal birth weight was the key outcome. Secondary outcomes included maternal weight gain, the incidence of preeclampsia, and neonatal adverse effects (miscarriage, stillbirth and congenital anomalies). Results: Pooled data from two RCTs (n=843) showed that metformin caused a significant reduction in maternal gestational weight gain (MD-1.35, 95% CI: [2.08, -0.630]), compared to placebo. The summary effect-estimate did not favor either of the two groups in terms of reduction of neonatal birth weight Z score (MD-0.09, 95% CI: [0.23, 0.06]). Metformin was associated with 41% reduction in the risk of preeclampsia; however, this reduction was not statistically significant [RR 0.59, 95% CI: [0.03, 11.46]). None of the neonatal adverse events including stillbirth [RR 1.14, 95% CI: 0.42, 3.10]) and congenital anomalies (RR= 1.36, 95% CI: [0.58, 3.21]) differed significantly between the two groups. Conclusion: For obese pregnant women, metformin could decrease gestational weight gain with no significant reduction in neonatal birth weight. In light of the current evidence, metformin should not be used to prevent poor pregnancy outcomes in obese non-diabetic women. |
| Databáze: | OpenAIRE |
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