Diabetes linked to poor pregnancy outcomes

By Julie Griffiths on 22 December 2017 Diabetes

Diabetes – but not a diabetes drug – has been linked to poor pregnancy outcomes.

New research has indicated that pregnant women with pre-gestational diabetes who take metformin are at a higher risk for adverse pregnancy outcomes than the general population. The poor outcomes include major birth defects and pregnancy loss.

The increased risk is due to diabetes, not metformin, found the research.

Metformin is used to treat type 2 diabetes, polycystic ovary syndrome associated infertility, and gestational diabetes. Human studies evaluating the safety of metformin in early pregnancy are scarce, said the paper.

The findings come from a British Journal of Clinical Pharmacology study including 471 women in the metformin group and 479 in the reference group.

The researchers evaluated the risk of major birth defects and pregnancy losses in a cohort of pregnant women exposed to metformin during 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.

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.

The risk of pregnancy losses (miscarriages and stillbirths) was 20.8% in women on metformin during the first trimester and 10.8% in the reference group.

Lead author Dr. Alice Panchaud from the Harvard T.H. Chan School of Public Health, Lausanne University Hospital, and Geneva University said: ‘Our findings provide the first reassuring evidence that metformin might offer a cheaper and simpler alternative to insulin for the management of pre-gestational diabetes in pregnancy when effective.’