Can metformin reduce the incidence of gestational diabetes mellitus in pregnant women with polycystic ovary syndrome? Prospective cohort study.
BACKGROUND
Women with polycystic ovary syndrome (PCOS) are at a high risk to develop Gestational Diabetes mellitus (GDM). We hypothesized that metformin due to its metabolic, endocrine, vascular, and anti-inflammatory effects may reduce the incidence of GDM in PCOS women.


METHODS
We carried out a prospective cohort study to determine the beneficial effects of metformin on PCOS patients during pregnancy. Three-hundred and sixty non-diabetic PCOS patients were included who were conceived on metformin by different treatment modalities. Two-hundred pregnant women continued on metformin at a dose of 1000-2000 mg daily throughout pregnancy (study group) and 160 women discontinued metformin use at the time of conception (control group).


RESULTS
There is a statistically significant reduction in the incidence of GDM in favor of metformin group (OR: 0.17, 95% CI: 0.07-0.37). There is a statistically significant reduction in the incidence of pre-eclampsia in favor of metformin group (OR: 0.35, 95% CI: 0.13-0.94).


CONCLUSIONS
Metformin is a promising medication for the prevention or reduction of the incidence of GDM and pre-eclampsia in PCOS women.
Egyptian International fertility & IVF Center, Miser International Hospital, Cairo, Egypt.
S
S
Khattab
I A
IA
Mohsen
I
I
Aboul Foutouh
H S
HS
Ashmawi
M N
MN
Mohsen
M
M
van Wely
F
F
van der Veen
M Af
MA
Youssef
D015746:Abdominal Pain / Q000139:chemically induced; D000328:Adult; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000209:etiology / Q000517:prevention & control*; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D007315:Insemination, Artificial; D007333:Insulin Resistance; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000503:physiopathology*; D011225:Pre-Eclampsia / Q000209:etiology / Q000517:prevention & control; D016742:Preconception Care; D011247:Pregnancy; D011446:Prospective Studies
D007004:Hypoglycemic Agents; D008687:Metformin