Efficacy of Prophylactic Use of Metformin in Prevention of Gestational Diabetes Mellitus in Nondiabetic Obese Pregnant Women

Background & Objective: Maternal obesity can increases pregnancy consequences like postpartum hemorrhage, preeclampsia, need for cesarean section, neonatal death, and fetal macrosomia. In this study, the efficacy of prophylactic use of metformin to prevent gestational diabetes mellitus in nondiabetic pregnant women with obesity was examined. Materials & Methods: This study was a clinical trial. Totally, ۳۴۰ pregnant women who were in the first trimester were referred to the gynecology clinic of Motahhari hospital in Urmia after ensuring the absence of underlying diseases such as diabetes, hypertension, kidney, liver, and cardiovascular disease, without a history of allergy to metformin, in case of a singleton pregnancy, and Body Mass Index (BMI) above ۳۰ were allocated to two equal groups. The intervention group was given ۱۰۰۰ mg of metformin, and the control group was given a placebo. Demographic information, including age, gravity, parity, live birth, birth, and maternal weight, previous delivery method, abortion, delivery method with its cause, polyhydramnios, NICU hospitalization, gestational age, mortality, and neonatal anomalies was also recorded. The results were analyzed using SPSS version ۲۶. Results: In the control group, ۱۵ mothers (۹.۴%) out of ۱۶۰ people, and in the intervention group, ۱۳ mothers (۸.۱%) had gestational diabetes (P=۰.۶۹۲). In the intervention group, the mean insulin dose was ۱۰.۸ ±۳ units; in the control group, the mean insulin dose was ۲۱.۲±۱۵.۷ units (P=۰.۰۴۸). Twenty patients (۶.۷%) out of ۲۹۷ obese patients and ۸ patients (۳۴.۸%) in the morbid obesity group had diabetes (P<۰.۰۰۱). In the control group, the mean weight of mothers was ۸.۰۴±۲.۵ kg; in the intervention group, it was ۵.۲±۲.۳ kg during pregnancy (P<۰.۰۰۱). Gestational diabetes, delivery method, death one week after birth, preterm birth, polyhydramnios, and intensive care unit were similar in the two groups. Conclusion: Metformin in pregnant women with a BMI>۳۰ deals with low maternal weight, reduced birth weight, and reduced insulin dose in diabetic mothers.

Keywords:

Diabetes , Metformin , Preeclampsia , Pregnant , Prevention