Effect of metformin on pregnancy outcome in healthy overweight pregnant women; a double-blinded parallel randomized clinical trial

Introduction: Maternal obesity increases the risk of pregnancy complications such as preeclampsia, postpartum hemorrhage, weight gain at birth and the need for cesarean section. Interventions that can help prevent fetal macrosomia and its adverse metabolic effects during pregnancy seem to help improve the lives of neonate in future.Objectives: Recently, the role of hyperglycemia and insulin resistance has been cited as factors that lead to increased maternal weight gain during pregnancy and fetal macrosomia and gestational diabetes. And in this study, we studied the role of metformin in overweight of mothers.Patients and Methods: ۳۶۰ pregnant women at ۱۲-۱۶ weeks of pregnancy referred to the gynecology clinic of Motahhari hospital in Urmia were randomly assigned to the two groups of ۱۸۰ individuals. The intervention group was given ۱۰۰۰ mg of metformin and the control group was given placebo. Demographic characteristics of patients such as age, gravidity, parity, preterm infant weight, live birth, abortion, previous delivery method, maternal weight, BMI, birth weight, delivery method, blood sugar at birth, hospitalization rate in NICU, gestational age at birth, neonatal hypoglycemia, infant mortality and anomalies were also recorded. The results were analyzed and evaluated with SPSS ۲۱.Results: Out of ۱۸۰ patients, ۱۶۹ patients remained in the intervention group and ۱۷۱ patients remained in the control group. The demographic characteristics of the mothers were the same in the both groups. In the control group, ۱۲ people (۷%) and in the intervention group, ۱۱ people (۶.۵%) had gestational diabetes (P=۰.۸). In the control group, ۱۳ infants (۷.۶%) and in the intervention group, ۱۲ infants (۷.۱%) had a birth weight more than ۴,۰۰۰ g (P=۰.۸). In the control group, ۱۳ patients (۷.۶%) and in the intervention group, ۵ patients (۲.۹%) had maternal preeclampsia and increased blood pressure during pregnancy (P= ۰.۰۵۳). In the control group, the mean weighting of mothers was ۱۰.۲۲ ± ۳.۳ kg and in the intervention group were ۷.۶ ± ۲.۳ kg during pregnancy (P <۰.۰۰۱).Conclusion: The use of metformin has been shown to be effective in controlling overweight in overweight mothers, but has not affected the birth weight of infants. Metformin has not had an effect on pregnancy results.

Keywords:

Metformin , Pregnancy , Overweight , Birth weight , Preeclampsia