Metformin, pre‐eclampsia, and pregnancy outcomes in women with polycystic ovary syndrome

Publisher Website
Google Scholar
Abstract
Aims  Was metformin during pregnancy in women with polycystic ovary syndrome (PCOS) associated with pre‐eclampsia, and was it safe for mother and neonate?Methods  In the current study, pre‐eclampsia and other pregnancy outcomes were prospectively studied in 90 women with PCOS who conceived on metformin 1.5–2.55 g/day, and had ≥ 1 live birth (97 pregnancies, 100 live births) compared with 252 healthy women (not known to have PCOS) with ≥ 1 live birth, consecutively delivered in a community obstetrics practice.Results  Women with PCOS were older than controls (33 ± 5 vs. 29 ± 6 years, P < 0.0001), more likely to be > 35 years old at conception (23 vs. 13%, P = 0.028), much heavier (93 ± 23 vs. 72 ± 18 kg, P < 0.0001, BMI 33.8 ± 7.8 kg/m2 vs. 25.6 ± 5.9, P < 0.0001), and more likely to be Caucasian (97 vs. 90%, P = 0.05), but there were similar numbers with preconception Type 2 diabetes mellitus [2/90 (2.2%) vs. 1/252 (0.4%), P = 0.17]. Pre‐eclampsia in PCOS (5/97 pregnancies, 5.2%), did not differ (P = 0.5) from controls (9/252, 3.6%), nor did it differ (P = 1.0) in PCOS vs. control primigravidas [2/45 (4.4%) vs. 4/91 (4.4%)]. Development of gestational diabetes in PCOS did not differ from controls [9/95 pregnancies (9.5%) vs. 40/251 (15.9%), P = 0.12]. Of the 100 live births to 90 women with PCOS, there were no major birth defects. Mean ± sd birth weight of the 80 live births ≥ 37 weeks gestation in women with PCOS (3414 ± 486 g) did not differ from controls’ 206 live births ≥ 37 weeks (3481 ± 555 g), P = 0.34, nor did the percentage of ≥ 37 week gestation neonates ≥ 4000 g (12.5 vs. 17.5%, P = 0.3) or ≥ 4500 g (1.3 vs. 2.9%, P = 0.7).Conclusions  Metformin is not associated with pre‐eclampsia in pregnancy in women with PCOS, and appears to be safe for mother and fetus.