Discipline of Obstetrics & Gynaecology, and The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
Women's and Babies Division, Department of Obstetrics and Gynaecology, The Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Pediatr Obes. 2023 Jan;18(1):e12974. doi: 10.1111/ijpo.12974. Epub 2022 Sep 12.
Metformin for women with overweight or obesity during pregnancy has been evaluated in randomized trials to reduce adverse pregnancy and birth outcomes. The effect on longer-term child health remains of interest.
To evaluate the effect of in-utero exposure to metformin on child health compared with no exposure.
We assessed children born to 513 women who participated in the Metformin in addition to dietary and lifestyle advice for pregnant women with overweight or obesity: the GRoW randomized trial, where women were randomized to receive either metformin or placebo during pregnancy. Child weight, height, anthropometry, diet, physical activity and neurodevelopment were assessed at six and 18 months and three to five years of age. The main outcome was BMI z-score > 85th centile for age and sex.
The number of children with BMI >85th centile was similar between treatment groups at all time points. At 18 months and three to five years of age, more than half of the children had a BMI z-score > 85th centile, indicating a high risk of childhood obesity.
We did not show evidence of the benefit of metformin for children of women with overweight or obesity during pregnancy adding to the growing literature on the lack of effect of pregnancy interventions in reducing longer-term risks of childhood obesity.
已有随机试验评估了妊娠期间超重或肥胖女性使用二甲双胍以降低不良妊娠和出生结局的效果。其对儿童长期健康的影响仍值得关注。
评估与无暴露相比，子宫内接触二甲双胍对儿童健康的影响。
我们评估了 513 名女性所生孩子的情况，这些女性参与了超重或肥胖孕妇的二甲双胍加饮食和生活方式建议：GRoW 随机试验，其中女性在妊娠期间被随机分配接受二甲双胍或安慰剂。在 6 个月、18 个月和 3 至 5 岁时评估儿童的体重、身高、人体测量、饮食、身体活动和神经发育情况。主要结局是年龄和性别为 85 百分位以上的 BMI z 评分>。
在所有时间点，治疗组的儿童 BMI>85 百分位的人数相似。在 18 个月和 3 至 5 岁时，超过一半的儿童 BMI z 评分>85 百分位，表明有发生儿童肥胖的高风险。
我们没有证据表明在超重或肥胖的孕妇中添加二甲双胍对儿童有益，这增加了关于妊娠干预措施无法降低儿童期肥胖长期风险的越来越多的文献。
