title: Effects of metformin-diet intervention before and throughout pregnancy on obstetric and neonatal outcomes in patients with polycystic ovary syndrome.
abstract: OBJECTIVE
  Prospectively assess whether metformin/diet pre-conception and throughout pregnancy would safely reduce first trimester miscarriage and improve pregnancy outcomes in women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  In 76 PCOS women, first pregnancy miscarriage and live birth were compared before and on metformin/diet, started 6.8 months (median) before conception, continued throughout pregnancy. On metformin 2-2.55 g/day, low glycemic index diet, first pregnancy outcomes in PCOS were compared with 156 community obstetric practice women (controls).
  
  
  METHODS
  Live births, miscarriage, birth <37 weeks gestation, gestational diabetes, pre-eclampsia, fetal macrosomia.
  
  
  RESULTS
  In 76 PCOS women before metformin-diet, there were 36 miscarriages (47%) and 40 live births vs. 14 (18%) miscarriages and 62 live births on metformin-diet 6.8 months before conception and throughout pregnancy, p = 0.0004, OR 3.99, 95% CI 1.91-8.31. On metformin-diet, PCOS women did not differ (p > 0.08) from controls for birth <37 weeks gestation, gestational diabetes, pre-eclampsia, or fetal macrosomia.
  
  
  CONCLUSIONS
  Metformin-diet before and during pregnancy in PCOS reduces miscarriage and adverse pregnancy outcomes. Study limitation: individual benefits of the diet alone and diet plus metformin could not be assessed separately. Randomized, controlled clinical trials now need to be done with a larger number of patients.
authors.affiliation: Cholesterol Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA. CJGlueck@health-partners.org
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Glueck
authors.forename: Naila
authors.initials: N
authors.lastname: Goldenberg
authors.forename: Joel
authors.initials: J
authors.lastname: Pranikoff
authors.forename: Zia
authors.initials: Z
authors.lastname: Khan
authors.forename: Jagjit
authors.initials: J
authors.lastname: Padda
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology / Q000517:prevention & control; D000328:Adult; D016640:Diabetes, Gestational / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D050498:Live Birth; D008687:Metformin / Q000008:administration & dosage*; D011085:Polycystic Ovary Syndrome / Q000628:therapy*; D011225:Pre-Eclampsia / Q000628:therapy; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin