Oral hypoglycaemic agents in 118 diabetic pregnancies.
OBJECTIVE
To assess maternal and neonatal complications in pregnancies of diabetic women treated with oral hypoglycaemic agents during pregnancy.


METHODS
A cohort study including all consecutively registered, orally treated pregnant diabetic patients set in a diabetic obstetrical service at a university hospital: 50 women treated with metformin, 68 women treated with sulphonylurea during pregnancy and a reference group of 42 diabetic women treated with insulin during pregnancy.


RESULTS
The prevalence of pre-eclampsia was significantly increased in the group of women treated with metformin compared to women treated with sulphonylurea or insulin (32 vs. 7 vs. 10%, P < 0.001). No difference in neonatal morbidity was observed between the orally treated and insulin-treated group; no cases of severe hypoglycaemia or jaundice were seen in the orally treated groups. However, in the group of women treated with metformin in the third trimester, the perinatal mortality was significantly increased compared to women not treated with metformin (11.6 vs. 1.3%, P < 0.02).


CONCLUSIONS
Treatment with metformin during pregnancy was associated with increased prevalence of pre-eclampsia and a high perinatal mortality.
Hellmuth
E
E
Department of Obstetrics and Gynaecology, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Denmark.
Damm
P
P
Mølsted-Pedersen
L
L
D000037:Abruptio Placentae / Q000453:epidemiology; D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D016640:Diabetes, Gestational / Q000188:drug therapy*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000145:classification / Q000453:epidemiology; D007328:Insulin / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D009017:Morbidity; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000188:drug therapy*; D014044:Tolbutamide / Q000627:therapeutic use*
D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D014044:Tolbutamide