Metformin Use in Pregnancy: Promises and Uncertainties

摘要

Metformin has been prescribed in pregnancy for more than 40 years, but it is since its increased use in polycystic ovarian syndrome treatment that exposure of the fetus to metformin in early pregnancy and its safety for both mother and child have been investigated more robustly. This review discusses the history, key trials, and controversies associated with metformin use in pregnancy. Metformin appears to be safe for use in early pregnancy, and findings do not suggest an increase in congenital malformations or miscarriages associated with its use. Short-term outcomes comparing metformin to insulin for treating gestational diabetes from trial and meta-analysis findings support its use, but there are fewer long-termand safety outcome data in this setting. In addition, there is not enough evidence to recommend its use as an additional agent for managing diabetes mellitus type 2 in pregnancy.