Major malformations risk following early pregnancy exposure to metformin: a systematic review and meta-analysis.
Metformin
Polycystic Ovary Syndrome
Pregnancy
Type 2 Diabetes
Journal
BMJ open diabetes research & care
ISSN: 2052-4897
Titre abrégé: BMJ Open Diabetes Res Care
Pays: England
ID NLM: 101641391
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
21
04
2022
accepted:
20
01
2023
entrez:
31
1
2023
pubmed:
1
2
2023
medline:
3
2
2023
Statut:
ppublish
Résumé
Metformin is considered as first-line treatment for type 2 diabetes and an effective treatment for polycystic ovary syndrome (PCOS). However, evidence regarding its safety in pregnancy is limited. We conducted a systematic review and meta-analysis of major congenital malformations (MCMs) risk after first-trimester exposure to metformin in women with PCOS and pregestational diabetes mellitus (PGDM). Randomized controlled trials (RCTs) and observational cohort studies with a control group investigating risk of MCM after first-trimester pregnancy exposure to metformin were searched until December 2021. ORs and 95% CIs were calculated separately according to indications and study type using Mantel-Haenszel method; outcome data were combined using random-effects model. Eleven studies (two RCTs; nine observational cohorts) met the inclusion criteria: four included pregnant women with PCOS, four included those with PGDM and three evaluated both indications separately and were considered in both indication groups. In PCOS group, there were two RCTs (57 exposed, 52 control infants) and five observational studies (472 exposed, 1892 control infants); point estimates for MCM rates in RCTs and observational studies were OR 0.93 (95% CI 0.09 to 9.21) (I
Identifiants
pubmed: 36720508
pii: 11/1/e002919
doi: 10.1136/bmjdrc-2022-002919
pmc: PMC9890805
pii:
doi:
Substances chimiques
Metformin
9100L32L2N
Hypoglycemic Agents
0
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
BMJ. 2018 Jun 25;361:k2477
pubmed: 29941493
Diabetes Res Clin Pract. 2014 Jun;104(3):353-7
pubmed: 24768511
Acta Diabetol. 2014 Oct;51(5):731-8
pubmed: 24633859
J Hum Reprod Sci. 2020 Oct-Dec;13(4):261-271
pubmed: 33627974
Diabet Med. 2003 Sep;20(9):734-8
pubmed: 12925053
BMJ. 2006 Sep 16;333(7568):597-600
pubmed: 16974018
J Diabetes Res. 2015;2015:325851
pubmed: 25874236
Diabetes Care. 2012 Jun;35(6):1364-79
pubmed: 22517736
Womens Health Issues. 2013 Jan;23(1):e39-45
pubmed: 23312713
Cell Metab. 2014 Dec 2;20(6):953-66
pubmed: 25456737
S Afr Med J. 1984 Apr 21;65(16):635-7
pubmed: 6369573
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120
Fertil Steril. 2006 Sep;86(3):658-63
pubmed: 16879826
PLoS One. 2015 May 06;10(5):e0125712
pubmed: 25945500
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
J Clin Endocrinol Metab. 2002 Feb;87(2):524-9
pubmed: 11836280
Diabetes Res Clin Pract. 2018 Mar;137:47-55
pubmed: 29325773
Br J Clin Pharmacol. 2015 Nov;80(5):1224-34
pubmed: 25925501
J Matern Fetal Neonatal Med. 2017 Aug;30(15):1874-1881
pubmed: 27549367
BMC Pregnancy Childbirth. 2020 Sep 4;20(1):512
pubmed: 32887578
Teratology. 1994 Apr;49(4):260-6
pubmed: 8073364
Diabetes Res Clin Pract. 2012 Dec;98(3):422-9
pubmed: 23068960
Diabetes Technol Ther. 2020 Feb;22(2):96-102
pubmed: 31621408
Reprod Toxicol. 2018 Oct;81:79-83
pubmed: 30017588
Hum Reprod Update. 2014 Sep-Oct;20(5):656-69
pubmed: 24861556
Diabetologia. 2012 Feb 8;:
pubmed: 22314812
Trends Endocrinol Metab. 2004 Nov;15(9):425-31
pubmed: 15519889
Diabetologia. 2017 Sep;60(9):1586-1593
pubmed: 28770321
Endocrinol Metab Clin North Am. 2011 Dec;40(4):727-38
pubmed: 22108277
Diabetes Care. 2016 Feb;39(2):187-9
pubmed: 26798149
Br J Clin Pharmacol. 2018 Mar;84(3):568-578
pubmed: 29215149
BMJ. 2006 Jun 24;332(7556):1485
pubmed: 16769748
PLoS One. 2013 May 27;8(5):e64585
pubmed: 23724063
Diabetes Care. 2007 Jul;30 Suppl 2:S220-4
pubmed: 17596476
Curr Diab Rep. 2012 Feb;12(1):24-32
pubmed: 22167469
N Engl J Med. 2008 May 8;358(19):2003-15
pubmed: 18463376
Cochrane Database Syst Rev. 2019 Oct 3;10:ED000142
pubmed: 31643080
Diabet Med. 1994 Jun;11(5):471-4
pubmed: 8088125
Endocr Rev. 2021 Jan 28;42(1):77-96
pubmed: 32897388
J Clin Endocrinol Metab. 2005 Jul;90(7):4068-74
pubmed: 15840746
Arch Dis Child Fetal Neonatal Ed. 2016 Nov;101(6):F488-F493
pubmed: 26912348
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
Reprod Toxicol. 2018 Sep;80:85-91
pubmed: 29857030
Int J Reprod Biomed. 2017 Aug;15(8):461-470
pubmed: 29082364
J Matern Fetal Neonatal Med. 2021 Aug;34(16):2741-2753
pubmed: 31558075
Diabetologia. 2006 Mar;49(3):434-41
pubmed: 16477438
C R Hebd Seances Acad Sci. 1961 Jul 10;253:321-3
pubmed: 13778533
Arch Gynecol Obstet. 2015 Jul;292(1):111-20
pubmed: 25547060
Hum Reprod Update. 2013 Jul-Aug;19(4):330-53
pubmed: 23449641
BMC Pregnancy Childbirth. 2016 Jul 19;16(1):173
pubmed: 27435163
Obstet Gynecol. 2009 Jan;113(1):193-205
pubmed: 19104375
Diabetes Obes Metab. 2017 Jun;19(6):765-772
pubmed: 28127850