Focus on Metformin: Its Role and Safety in Pregnancy and Beyond

• Published in: Drugs (New York, N.Y.) Vol. 83; no. 11; pp. 985 - 999
• Main Authors: Newman, Christine, Rabbitt, Louise, Ero, Adesuwa, Dunne, Fidelma P.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.07.2023; Springer Nature B.V
• Subjects: Antidiabetics; Chromium; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - chemically induced; Diabetes Mellitus, Type 2 - drug therapy; Diabetes, Gestational - drug therapy; Female; Humans; Hypoglycemic Agents - adverse effects; Infant; Infants; Insulin; Insulin resistance; Internal Medicine; Medicine; Medicine & Public Health; Metformin; Metformin - adverse effects; Metformin - therapeutic use; Obesity; Pharmacology/Toxicology; Pharmacotherapy; Pregnancy; Pregnancy complications; Review; Review Article; Side effects; Weight reduction; Womens health
• ISSN: 0012-6667; 1179-1950
• DOI: 10.1007/s40265-023-01899-0

Metformin is used worldwide in the treatment of type 2 diabetes and has been used in the treatment of diabetes in pregnancy since the 1970s. It is highly acceptable to patients due to its ease of administration, cost and adverse effect profile. It is effective in reducing macrosomia, large-for-gestational-age infants and reduces maternal weight gain. Despite its many advantages, metformin has been associated with reductions in foetal size and has been associated with an increase in infants born small-for-gestational-age in certain cohorts. In this article, we review its efficacy, adverse effects and long-term follow-up before, during and after pregnancy for both mother and infant. We also evaluate the other forms of treatment for gestational diabetes, including oral therapies, insulin therapy and emerging treatments.