多囊卵巢综合征女性孕期使用二甲双胍：随机对照研究的系统评价与荟萃分析
Gestational metformin administration in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized control studies.
作者信息
Cao Qi, Hu Yuanyuan, Fu Jing, Huang Xin, Wu Lukanxuan, Zhang Jiani, Huang Wei
机构信息
Department of Obstetrics and Gynaecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China.
出版信息
J Obstet Gynaecol Res. 2021 Dec;47(12):4148-4157. doi: 10.1111/jog.15044. Epub 2021 Sep 27.
AIMS
To evaluate metformin's effects on pregnancy outcomes in women with polycystic ovary syndrome.
METHODS
A literature search was conducted using PubMed, EMBASE, Web of Science, MEDLINE, and the Cochrane Library. All randomized controlled trials comparing metformin administration during pregnancy versus placebo or blank in PCOS women were selected. The primary outcomes were the incidence of gestational diabetes mellitus (GDM), preterm delivery, and miscarriage. We combined data with the Review Manager. Bayesian meta-analysis was employed for further verification with the R software.
RESULTS
Six randomized control trial studies involving 1229 participants were included. Metformin use was associated with reduced risk of preterm delivery (Risk ratios [RR], 0.45; 95% CI, 0.25-0.80; p, 0.007) and higher larger neonatal head circumference (Mean difference (MD), 0.47; 95% CI, 0.20-0.74; p, 0.0006] but had no effect on the incidence of GDM (RR 1.87; 95% CI, 0.58-1.87; p, 0.89), miscarriage (RR, 0.85; 95% CI, 0.45-1.60; p, 0.62), pre-eclampsia (RR, 1.18; 95% CI, 0.43-3.21; p, 0.75), neonatal length (MD, 0.33; 95% CI, -0.12-0.78; p, 0.15) and birthweight (MD, 73.78; 95% CI, -52.98-200.53; p, 0.17).
CONCLUSIONS
Metformin administration in PCOS pregnancies was associated with reduced preterm delivery risk and larger neonatal head circumference.
目的
评估二甲双胍对多囊卵巢综合征女性妊娠结局的影响。
方法
使用PubMed、EMBASE、Web of Science、MEDLINE和Cochrane图书馆进行文献检索。选择所有比较多囊卵巢综合征女性孕期服用二甲双胍与安慰剂或空白对照的随机对照试验。主要结局为妊娠期糖尿病（GDM）、早产和流产的发生率。我们使用Review Manager合并数据。采用贝叶斯荟萃分析并用R软件进行进一步验证。
结果
纳入了6项涉及1229名参与者的随机对照试验研究。使用二甲双胍与降低早产风险相关（风险比[RR]，0.45；95%置信区间[CI]，0.25 - 0.80；p，0.007）以及新生儿头围更大相关（平均差[MD]，0.47；95% CI，0.20 - 0.74；p，0.0006），但对GDM发生率（RR 1.87；95% CI，0.58 - 1.87；p，0.89）、流产（RR，0.85；95% CI, 0.45 - 1.60；p，0.62）、子痫前期（RR，1.18；95% CI，0.43 - 3.21；p，0.75）、新生儿身长（MD，0.33；95% CI， - 0.12 - 0.78；p，0.15）和出生体重（MD，73.78；95% CI， - 52.98 - 200.53；p，0.17）无影响。
结论
多囊卵巢综合征孕妇服用二甲双胍与降低早产风险和新生儿头围增大有关。
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