title: Cervical Length and Androgens in Pregnant Women With Polycystic Ovary Syndrome: Has Metformin Any Effect?
abstract: BACKGROUND
  Women with polycystic ovary syndrome (PCOS) have increased risk of preterm delivery. Shortening of the cervix is a sign of preterm delivery.
  
  
  OBJECTIVE
  This study aimed to investigate potential effect of metformin on cervical length and whether androgen levels correlate with cervical length in PCOS pregnancies.
  
  
  METHODS
  This was a sub-study of a randomized, placebo-controlled, multicenter study (The PregMet study) performed at 11 secondary or tertiary centers from 2005 to 2009.
  
  
  METHODS
  Two-hundred sixty-one pregnancies of 245 women with PCOS, age 18-42 years participated.
  
  
  METHODS
  Participants were randomly assigned to metformin or placebo from first trimester to delivery.
  
  
  METHODS
  We compared cervical length and androgen levels in metformin and placebo groups at gestational weeks 19 and 32. We also explored whether cervical length correlated with androgen levels.
  
  
  RESULTS
  We found no difference in cervical length between the metformin and the placebo groups at gestational week 19 and 32. Dehydroepiandrosterone (DHEAS) tended to be higher in the metformin group. There were no correlations between androgens and cervical length at week 19. At gestational week 32, androstenedione (P = .02) and DHEAS (P = .03) showed a trend toward negative correlation to cervical length. High androstenedione level correlated with shortening of cervical length from week 19 to 32 when adjusted for confounders (P = .003). T (P = .03), DHEAS (P = .02), and free testosterone index (P = .03) showed a similar trend.
  
  
  CONCLUSIONS
  Metformin in pregnancy did not affect cervical length in women with PCOS. High maternal androgen levels correlated with cervical shortening from the second to the third trimester of pregnancy, as a sign of cervical ripening.
authors.affiliation: Department of Obstetrics and Gynecology (T.S.L., S.S., E.V.) and Department of Endocrinology (S.M.C.), St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health (T.S.L., S.S., E.V.) and Department of Cancer Research and Molecular Medicine (S.M.D.), Norwegian University of Science and Technology, 7491 Trondheim, Norway; and Department of Public Health and General Practice (Ø.S.), 7491 Trondheim, Norway.
authors.forename: Tone
authors.initials: T
authors.lastname: Shetelig Løvvik
authors.affiliation: Department of Obstetrics and Gynecology (T.S.L., S.S., E.V.) and Department of Endocrinology (S.M.C.), St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health (T.S.L., S.S., E.V.) and Department of Cancer Research and Molecular Medicine (S.M.D.), Norwegian University of Science and Technology, 7491 Trondheim, Norway; and Department of Public Health and General Practice (Ø.S.), 7491 Trondheim, Norway.
authors.forename: Solhild
authors.initials: S
authors.lastname: Stridsklev
authors.affiliation: Department of Obstetrics and Gynecology (T.S.L., S.S., E.V.) and Department of Endocrinology (S.M.C.), St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health (T.S.L., S.S., E.V.) and Department of Cancer Research and Molecular Medicine (S.M.D.), Norwegian University of Science and Technology, 7491 Trondheim, Norway; and Department of Public Health and General Practice (Ø.S.), 7491 Trondheim, Norway.
authors.forename: Sven M
authors.initials: SM
authors.lastname: Carlsen
authors.affiliation: Department of Obstetrics and Gynecology (T.S.L., S.S., E.V.) and Department of Endocrinology (S.M.C.), St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health (T.S.L., S.S., E.V.) and Department of Cancer Research and Molecular Medicine (S.M.D.), Norwegian University of Science and Technology, 7491 Trondheim, Norway; and Department of Public Health and General Practice (Ø.S.), 7491 Trondheim, Norway.
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Salvesen
authors.affiliation: Department of Obstetrics and Gynecology (T.S.L., S.S., E.V.) and Department of Endocrinology (S.M.C.), St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health (T.S.L., S.S., E.V.) and Department of Cancer Research and Molecular Medicine (S.M.D.), Norwegian University of Science and Technology, 7491 Trondheim, Norway; and Department of Public Health and General Practice (Ø.S.), 7491 Trondheim, Norway.
authors.forename: Eszter
authors.initials: E
authors.lastname: Vanky
mesh_terms: D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D054791:Cervical Length Measurement; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000188:drug therapy*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D055815:Young Adult
chemical_list: D000728:Androgens; D007004:Hypoglycemic Agents; D000735:Androstenedione; D019314:Dehydroepiandrosterone Sulfate; D008687:Metformin