Pregnancy outcomes in women on metformin for diabetes or other indications among those seeking teratology information services.

Détails

ID Serval
serval:BIB_B81A0F10409F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Pregnancy outcomes in women on metformin for diabetes or other indications among those seeking teratology information services.
Périodique
British journal of clinical pharmacology
Auteur(s)
Panchaud A., Rousson V., Vial T., Bernard N., Baud D., Amar E., De Santis M., Pistelli A., Dautriche A., Beau-Salinas F., Cassina M., Dunstan H., Passier A., Kaplan Y.C., Duman M.K., Maňáková E., Eleftheriou G., Klinger G., Winterfeld U., Rothuizen L.E., Buclin T., Csajka C., Hernandez-Diaz S.
ISSN
1365-2125 (Electronic)
ISSN-L
0306-5251
Statut éditorial
Publié
Date de publication
03/2018
Peer-reviewed
Oui
Volume
84
Numéro
3
Pages
568-578
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Metformin is used to treat type 2 diabetes, polycystic ovary syndrome associated infertility, and gestational diabetes. This study aims to evaluate the safety of metformin in early pregnancy.
We evaluated the risk of major birth defects and pregnancy losses in a cohort of pregnant women exposed to metformin during the first trimester for different indications relative to a matched unexposed reference group.
The risk of major birth defects was 5.1% (20/392) in pregnancies exposed to metformin during the first trimester and 2.1% (9/431) in the reference group [adjusted odds ratio (OR) 1.70; 95% CI 0.70-4.38]. Among metformin users, this risk was 7.8% (17/219) in patients with pre-gestational diabetes and 1.7% (3/173) in those without this diagnosis. Compared to the unexposed reference, the OR for metformin user with diabetes was 3.95 (95% CI 1.77-9.41) and for metformin with other indications it was 0.83 (95% CI 0.18-2.81). The risk of pregnancy losses (spontaneous abortions and stillbirths) was 20.8% in women on metformin during the first trimester and 10.8% in the reference group [adjusted hazard ratio (HR) 1.57; 95% CI 0.90-2.74]. The risks for women on metformin with and without pre-gestational diabetes were 24.0% and 16.8% respectively, with adjusted HR of 2.51 (95% CI 1.44-4.36) and 1.38 (95% CI 0.74-2.59) when compared to the reference.
Pregnant women with pre-gestational diabetes on metformin are at a higher risk for adverse pregnancy outcomes than the general population. This appears to be due to the underlying diabetes since women on metformin for other indications do not present meaningfully increased risks.

Mots-clé
diabetes, metformin, observational study, pregnancy, spontaneous abortion, teratogen
Pubmed
Web of science
Création de la notice
08/12/2017 10:34
Dernière modification de la notice
20/08/2019 15:26
Données d'usage