Efficacy of metformin on pregnancy complications in women with polycystic ovary syndrome: a meta-analysis

Abstract

Objective: To evaluate the efficacy of metformin administration throughout pregnancy on pregnancy-related complications in women with polycystic ovary syndrome (PCOS).

Study design: MEDLINE and ScienceDirect were searched to retrieve relevant trials. The endpoint was the incidence of complications of pregnancy, gestational diabetes mellitus (GDM), pre-eclampsia (PE), miscarriage and premature birth included.

Results: Five studies with 502 PCOS patients with metformin administration throughout pregnancy and 427 controls who used metformin just to get conception were included in our meta-analysis. In study group, a significantly lower change of emerging miscarriage and premature birth was observed, the pooled relative risk (RR) was 0.32 (95% confidence interval (CI): 0.19–0.56) for miscarriage and 0.40 (95%CI: 0.18–0.91) for premature birth. No significant difference was demonstrated in emerging GDM and PE.

Conclusions: Metformin therapy throughout pregnancy can reduce the RR of miscarriage and premature birth incidence in PCOS patients with no serious side effects.

Chinese abstract

目的：妊娠期间给予多囊卵巢综合征（PCOS）患者二甲双胍，评估二甲双胍对妊娠相关并发症的疗效。

研究设计：在MEDLINE和ScienceDirect上检索相关研究。终点为妊娠期并发症发生率，包括妊娠期糖尿病（GDM），子痫前期（PE），流产和早产。

结果：我们的meta分析包括5项共502例妊娠期间给予二甲双胍治疗的PCOS患者和427例使用二甲双胍后怀孕的对照人群。实验组观察到流产和早产率显著降低，综合后流产的相对风险（RR）为0.32（95%置信区间（CI）：0.19-056），早产的RR为0.40（95%CI:0.18-0.91）。出现GDM和PE的发生率无统计学差异。

结论：妊娠期间对PCOS患者给予二甲双胍可降低流产和早产的发生率且无严重副作用。

• Metformin
• miscarriage
• polycystic ovary syndrome
• pregnancy complications
• premature birth

Acknowledgements

The authors are grateful to Yong Gan, for his critical revision and academic help of this article. Feng Zhou made substantial contributions to design, manual searching, statistical analysis and proofreading of the article. All hard work of listed authors is worth appreciated and applauded.

Declaration of interest

The authors declare no conflicts of interests. The authors alone are responsible for the content and writing of this article.