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).

RESEARCH DESIGN AND 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).

MAIN OUTCOME MEASURES:

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: Charles J Glueck, Naila Goldenberg, Joel Pranikoff, Zia Khan, Jagjit Padda, Ping Wang
• Journal: Current medical research and opinion (Curr Med Res Opin) Vol. 29 Issue 1 Pg. 55-62 (Jan 2013) ISSN: 1473-4877 [Electronic] England
• PMID: 23205605 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hypoglycemic Agents
• Metformin

Topics

• Abortion, Spontaneous (etiology, prevention & control)
• Adult
• Diabetes, Gestational (etiology, prevention & control)
• Female
• Fetal Macrosomia (etiology, prevention & control)
• Humans
• Hypoglycemic Agents (administration & dosage)
• Live Birth
• Metformin (administration & dosage)
• Polycystic Ovary Syndrome (therapy)
• Pre-Eclampsia (therapy)
• Pregnancy
• Prospective Studies