Department of Endocrinology, Epsom and St. Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton SM5 1AA, Surrey, UK.
Department of Maternal Medicine, Epsom and St. Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton SM5 1AA, Surrey, UK.
Int J Mol Sci. 2018 Jul 4;19(7):1954. doi: 10.3390/ijms19071954.
Metformin use in pregnancy is increasing worldwide as randomised controlled trial (RCT) evidence is emerging demonstrating its safety and efficacy. The Metformin in Gestational Diabetes (MiG) RCT changed practice in many countries demonstrating that metformin had similar pregnancy outcomes to insulin therapy with less maternal weight gain and a high degree of patient acceptability. A multicentre RCT is currently assessing the addition of metformin to insulin in pregnant women with type 2 diabetes. RCT evidence is also available for the use of metformin in pregnancy for women with Polycystic Ovarian Syndrome and for nondiabetic women with obesity. No evidence of an increase in congenital malformations or miscarriages has been observed even when metformin is started before pregnancy and continued to term. Body composition and metabolic outcomes at two, seven, and nine years have now been reported for the offspring of mothers treated in the MiG study. In this review, we will briefly discuss the action of metformin and then consider the evidence from the key clinical trials.
二甲双胍在妊娠中的应用正在全球范围内增加，因为随机对照试验（RCT）的证据表明其安全性和有效性。二甲双胍治疗妊娠糖尿病（MiG）RCT 改变了许多国家的实践，表明二甲双胍与胰岛素治疗具有相似的妊娠结局，且体重增加较少，患者接受度较高。一项多中心 RCT 目前正在评估在患有 2 型糖尿病的孕妇中添加二甲双胍与胰岛素的效果。对于多囊卵巢综合征和非糖尿病肥胖女性的妊娠应用，也有 RCT 证据。即使在妊娠前开始并持续到足月使用二甲双胍，也没有观察到先天性畸形或流产增加的证据。现在已经报道了 MiG 研究中治疗的母亲的后代在两年、七年和九年内的身体成分和代谢结果。在这篇综述中，我们将简要讨论二甲双胍的作用，然后考虑关键临床试验的证据。
