Effect of metformin on maternal and neonatal outcomes in pregnant obese diabetic patients: New potentials for an old drug

Document Type : Original Article

Authors

1 Associate Professor of Obstetrics and Gynecology, Faculty of Medicine, Cairo University

2 Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Cairo University

3 Professor of Obstetrics and Gynecology, Faculty of Medicine, Cairo University

4 Obstetrics and Gynecology Specialist

Abstract

Background: Pregnancy complicated by diabetes whether gestational or pregestational diabetes, could be associated with adverse maternal and neonatal outcomes; if optimum glycemic control was not achieved. Metformin is an insulin sensitizing drug that has been approved for treatment of gestational diabetes and type II pregestational diabetes. In this study, we have studied the role and effectiveness of metformin in improving glycemic control and the prevention of maternal and neonatal adverse outcomes in obese pregnant diabetic women.   
Patient and Methods: This was a prospective cohort study that included 189 obese pregnant diabetic women recruited to Kasr Al Aini Obstetrics and Gynecology department over the period from September 2022 till March 2023. The study population included three groups according to the treatment modality; metformin only group, metformin and insulin group and insulin only group.  
Results: The use of metformin was associated with significant reduction in the incidence of preeclampsia and neonatal lactic acidosis with a p value 0.033 and 0.002 respectively. However, use of metformin whether alone or in addition to insulin, compared to insulin alone was not shown to be superior in improving glycemic control, or reduce adverse neonatal outcomes..  
Conclusion: Metformin use in obese diabetic pregnant women improves maternal and neonatal outcomes. 

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