Metformin and pregnancy outcomes: Evidence gaps and unanswered questions

Autores
González, Claudio Daniel; Alvariñas, Jorge; Gonzalez Bagnes, Maria Florencia; Di Girolamo, Guillermo
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Metformin is sometimes used as an alternative to insulin in gestational diabetes mellitus (GDM). It is also used to achieve ovulation in polycystic ovary syndrome (PCOS). Pre-natal exposure to metformin results from its continuation after a successful ovulation in women with PCOS, its maintenance in women with pre-gestational diabetes or the installation of metformin in GDM. Little is known about the potential consequences of metformin exposure on pregnancy outcomes and offspring development. The aim of this review is to summarize the metformin effects on pregnancy outcomes and offspring development. Gaps in the available evidence and unanswered questions are also discussed. Methods: A comprehensive literature search was carried out to identify eligible studies from MEDLINE/PubMed, EMBASE and SCIELO databases through 1995 first semester. Results: Several factors limit the effect of metformin on embryos. In contrast, placental transport of metformin is effective allowing for a higher fetal exposure; the impact of this finding remains unclear. It seems that the interruption of metformin after a pregnancy diagnosis in women with PCOS is not associated with a higher miscarriage risk and it continuation does not seem to impair the maternal metabolic prognosis or prevent emerging GDM. Conclusions: It seems to have no sense to prolong the use of metformin after a pregnancy diagnosis in women with PCOS. Patients with GDM may be treated with metformin under on judicious basis, and a careful attachment to clinical guidelines and regulations is recommended. The long-term effects of pre-natal exposure to metformin on the offspring remain uncertain.
Fil: González, Claudio Daniel. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; Argentina
Fil: Alvariñas, Jorge. Sociedad Argentina de Diabetes; Argentina
Fil: Gonzalez Bagnes, Maria Florencia. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina
Fil: Di Girolamo, Guillermo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiologicas "prof. Dr. Alberto C. Taquini".; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Materia
GESTATIONAL DIABETES MELLITUS
HYPERTENSION
METFORMIN
POLYCYSTIC OVARY SYNDROME
PREECLAMPSIA
PREGNANCY OUTCOMES
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/122844
Acceder
id CONICETDig_040901e0825a5ba5af67aedde5622638
oai_identifier_str oai:ri.conicet.gov.ar:11336/122844
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Metformin and pregnancy outcomes: Evidence gaps and unanswered questionsGonzález, Claudio DanielAlvariñas, JorgeGonzalez Bagnes, Maria FlorenciaDi Girolamo, GuillermoGESTATIONAL DIABETES MELLITUSHYPERTENSIONMETFORMINPOLYCYSTIC OVARY SYNDROMEPREECLAMPSIAPREGNANCY OUTCOMEShttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: Metformin is sometimes used as an alternative to insulin in gestational diabetes mellitus (GDM). It is also used to achieve ovulation in polycystic ovary syndrome (PCOS). Pre-natal exposure to metformin results from its continuation after a successful ovulation in women with PCOS, its maintenance in women with pre-gestational diabetes or the installation of metformin in GDM. Little is known about the potential consequences of metformin exposure on pregnancy outcomes and offspring development. The aim of this review is to summarize the metformin effects on pregnancy outcomes and offspring development. Gaps in the available evidence and unanswered questions are also discussed. Methods: A comprehensive literature search was carried out to identify eligible studies from MEDLINE/PubMed, EMBASE and SCIELO databases through 1995 first semester. Results: Several factors limit the effect of metformin on embryos. In contrast, placental transport of metformin is effective allowing for a higher fetal exposure; the impact of this finding remains unclear. It seems that the interruption of metformin after a pregnancy diagnosis in women with PCOS is not associated with a higher miscarriage risk and it continuation does not seem to impair the maternal metabolic prognosis or prevent emerging GDM. Conclusions: It seems to have no sense to prolong the use of metformin after a pregnancy diagnosis in women with PCOS. Patients with GDM may be treated with metformin under on judicious basis, and a careful attachment to clinical guidelines and regulations is recommended. The long-term effects of pre-natal exposure to metformin on the offspring remain uncertain.Fil: González, Claudio Daniel. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; ArgentinaFil: Alvariñas, Jorge. Sociedad Argentina de Diabetes; ArgentinaFil: Gonzalez Bagnes, Maria Florencia. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Di Girolamo, Guillermo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiologicas "prof. Dr. Alberto C. Taquini".; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaBentham Science Publishers2019-03-13info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/122844González, Claudio Daniel; Alvariñas, Jorge; Gonzalez Bagnes, Maria Florencia; Di Girolamo, Guillermo; Metformin and pregnancy outcomes: Evidence gaps and unanswered questions; Bentham Science Publishers; Current Clinical Pharmacology; 14; 1; 13-3-2019; 54-601574-88472212-3938CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.eurekaselect.com/168564/articleinfo:eu-repo/semantics/altIdentifier/doi/10.2174/1574884714666181224151116info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:45:09Zoai:ri.conicet.gov.ar:11336/122844instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:45:09.547CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Metformin and pregnancy outcomes: Evidence gaps and unanswered questions
title Metformin and pregnancy outcomes: Evidence gaps and unanswered questions
spellingShingle Metformin and pregnancy outcomes: Evidence gaps and unanswered questions
González, Claudio Daniel
GESTATIONAL DIABETES MELLITUS
HYPERTENSION
METFORMIN
POLYCYSTIC OVARY SYNDROME
PREECLAMPSIA
PREGNANCY OUTCOMES
title_short Metformin and pregnancy outcomes: Evidence gaps and unanswered questions
title_full Metformin and pregnancy outcomes: Evidence gaps and unanswered questions
title_fullStr Metformin and pregnancy outcomes: Evidence gaps and unanswered questions
title_full_unstemmed Metformin and pregnancy outcomes: Evidence gaps and unanswered questions
title_sort Metformin and pregnancy outcomes: Evidence gaps and unanswered questions
dc.creator.none.fl_str_mv González, Claudio Daniel
Alvariñas, Jorge
Gonzalez Bagnes, Maria Florencia
Di Girolamo, Guillermo
author González, Claudio Daniel
author_facet González, Claudio Daniel
Alvariñas, Jorge
Gonzalez Bagnes, Maria Florencia
Di Girolamo, Guillermo
author_role author
author2 Alvariñas, Jorge
Gonzalez Bagnes, Maria Florencia
Di Girolamo, Guillermo
author2_role author
author
author
dc.subject.none.fl_str_mv GESTATIONAL DIABETES MELLITUS
HYPERTENSION
METFORMIN
POLYCYSTIC OVARY SYNDROME
PREECLAMPSIA
PREGNANCY OUTCOMES
topic GESTATIONAL DIABETES MELLITUS
HYPERTENSION
METFORMIN
POLYCYSTIC OVARY SYNDROME
PREECLAMPSIA
PREGNANCY OUTCOMES
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: Metformin is sometimes used as an alternative to insulin in gestational diabetes mellitus (GDM). It is also used to achieve ovulation in polycystic ovary syndrome (PCOS). Pre-natal exposure to metformin results from its continuation after a successful ovulation in women with PCOS, its maintenance in women with pre-gestational diabetes or the installation of metformin in GDM. Little is known about the potential consequences of metformin exposure on pregnancy outcomes and offspring development. The aim of this review is to summarize the metformin effects on pregnancy outcomes and offspring development. Gaps in the available evidence and unanswered questions are also discussed. Methods: A comprehensive literature search was carried out to identify eligible studies from MEDLINE/PubMed, EMBASE and SCIELO databases through 1995 first semester. Results: Several factors limit the effect of metformin on embryos. In contrast, placental transport of metformin is effective allowing for a higher fetal exposure; the impact of this finding remains unclear. It seems that the interruption of metformin after a pregnancy diagnosis in women with PCOS is not associated with a higher miscarriage risk and it continuation does not seem to impair the maternal metabolic prognosis or prevent emerging GDM. Conclusions: It seems to have no sense to prolong the use of metformin after a pregnancy diagnosis in women with PCOS. Patients with GDM may be treated with metformin under on judicious basis, and a careful attachment to clinical guidelines and regulations is recommended. The long-term effects of pre-natal exposure to metformin on the offspring remain uncertain.
Fil: González, Claudio Daniel. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; Argentina
Fil: Alvariñas, Jorge. Sociedad Argentina de Diabetes; Argentina
Fil: Gonzalez Bagnes, Maria Florencia. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina
Fil: Di Girolamo, Guillermo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiologicas "prof. Dr. Alberto C. Taquini".; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
description Background: Metformin is sometimes used as an alternative to insulin in gestational diabetes mellitus (GDM). It is also used to achieve ovulation in polycystic ovary syndrome (PCOS). Pre-natal exposure to metformin results from its continuation after a successful ovulation in women with PCOS, its maintenance in women with pre-gestational diabetes or the installation of metformin in GDM. Little is known about the potential consequences of metformin exposure on pregnancy outcomes and offspring development. The aim of this review is to summarize the metformin effects on pregnancy outcomes and offspring development. Gaps in the available evidence and unanswered questions are also discussed. Methods: A comprehensive literature search was carried out to identify eligible studies from MEDLINE/PubMed, EMBASE and SCIELO databases through 1995 first semester. Results: Several factors limit the effect of metformin on embryos. In contrast, placental transport of metformin is effective allowing for a higher fetal exposure; the impact of this finding remains unclear. It seems that the interruption of metformin after a pregnancy diagnosis in women with PCOS is not associated with a higher miscarriage risk and it continuation does not seem to impair the maternal metabolic prognosis or prevent emerging GDM. Conclusions: It seems to have no sense to prolong the use of metformin after a pregnancy diagnosis in women with PCOS. Patients with GDM may be treated with metformin under on judicious basis, and a careful attachment to clinical guidelines and regulations is recommended. The long-term effects of pre-natal exposure to metformin on the offspring remain uncertain.
publishDate 2019
dc.date.none.fl_str_mv 2019-03-13
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/122844
González, Claudio Daniel; Alvariñas, Jorge; Gonzalez Bagnes, Maria Florencia; Di Girolamo, Guillermo; Metformin and pregnancy outcomes: Evidence gaps and unanswered questions; Bentham Science Publishers; Current Clinical Pharmacology; 14; 1; 13-3-2019; 54-60
1574-8847
2212-3938
CONICET Digital
CONICET
url http://hdl.handle.net/11336/122844
identifier_str_mv González, Claudio Daniel; Alvariñas, Jorge; Gonzalez Bagnes, Maria Florencia; Di Girolamo, Guillermo; Metformin and pregnancy outcomes: Evidence gaps and unanswered questions; Bentham Science Publishers; Current Clinical Pharmacology; 14; 1; 13-3-2019; 54-60
1574-8847
2212-3938
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.eurekaselect.com/168564/article
info:eu-repo/semantics/altIdentifier/doi/10.2174/1574884714666181224151116
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Bentham Science Publishers
publisher.none.fl_str_mv Bentham Science Publishers
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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