Metformin use in pregnancy: promises and uncertainties

Lindsay, R. S. and Loeken, M. R. (2017) Metformin use in pregnancy: promises and uncertainties. Diabetologia, 60(9), pp. 1612-1619. (doi: 10.1007/s00125-017-4351-y) (PMID:28770325)

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Abstract

Metformin has been prescribed in pregnancy for over 40 years; for much of this time, use has been limited both in numbers and geographically, and the evidence base has been confined to observational studies. In early years, perceived safety concerns and lack of availability of the drug in many countries acted as a barrier to use. More recently, RCTs have begun to examine the role of metformin in pregnancy in much-needed detail. However, this evidence base has been interpreted differently in different countries, leading to very wide variation in its current application in pregnancy. In this short review, we will discuss the history of metformin in pregnancy and highlight some of the key clinical trials. We will then consider some of the remaining controversies associated with metformin use in pregnancy, most important of these being the potential for long-term ‘programming’ effects on the fetus as a result of metformin being able to cross the placenta. We will also consider clinical situations where metformin might be avoided. Finally, we will discuss some future directions for this drug as it reaches its sixtieth anniversary.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lindsay, Dr Robert
Authors: Lindsay, R. S., and Loeken, M. R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Diabetologia
Publisher:Springer
ISSN:0012-186X
ISSN (Online):1432-0428
Published Online:02 August 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Diabetologia 60(9):1612-1619
Publisher Policy:Reproduced under a Creative Commons License

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