SynthesisDiabetic medicine : a journal of the British Diabetic Association2018
Risk of pre-eclampsia in women taking metformin: a systematic review and meta-analysis.
Synthesis in Diabetic medicine : a journal of the British Diabetic Association, 2018. The graph read 1 number from its abstract, feeding 3 cells of the map: it finds no clear difference in 1. It is linked to trial NCT04855513 (Prevention of Pre-eclampsia Using Metformin), which is not on this map. Cited by 37 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
RESULTS: Overall, in five randomized controlled trials comparing metformin treatment (n = 611) with placebo/control (n = 609), no difference in the risk of pre-eclampsia was found [combined/pooled risk ratio (RR), 0.86 (95% CI 0.33-2.26); P = 0.76; I CONCLUSIONS: In studies randomizing pregnant women to glucose-lowering therapy, metformin was associated with lower gestational weight gain and a lower risk of pre-eclampsia compared with insulin.
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Insulin×pregnancy & neonatal
No readable resultOpen on the map →What to test next →No other readable study in this cell yet. This paper is the evidence.
Metformin×pregnancy & neonatal
InconclusiveOpen on the map →What to test next →3 readable studies in this cell: 0 favour the treatment, 3 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Other glucose-lowering×pregnancy & neonatal
No readable resultOpen on the map →What to test next →No other readable study in this cell yet. This paper is the evidence.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prevention of Pre-eclampsia Using Metformin: a Randomized Control Trial
Who cites it
37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Comparative effectiveness of statins, metformin, and vitamin D, for prevention of preeclampsia: a systematic review and network meta-analysis of randomized trials.BMC pregnancy and childbirth · 2026Pooled it
- Integrating Social and Clinical Determinants of Pre-Eclampsia: A Hierarchical Systematic Review and Conceptual Framework for Prevention.BJOG : an international journal of obstetrics and gynaecology · 2026Pooled it
- Metformin use and preeclampsia risk in women with diabetes: a two-country cohort analysis.BMC medicine · 2024 · on this mapPooled it
- Diabetes and anti-diabetic interventions and the risk of gynaecological and obstetric morbidity: an umbrella review of the literature.BMC medicine · 2023Pooled it
- The Effect of Metformin on Insulin Requirement, Glycaemic Control and Weight Gain in Type 1 Diabetes During Pregnancy-a Randomised, Placebo-Controlled Multicentre Study.Diabetes/metabolism research and reviews · 2025Trial
- Use of metformin to prolong gestation in preterm pre-eclampsia: randomised, double blind, placebo controlled trial.BMJ (Clinical research ed.) · 2021Trial
- Overlap of Gestational Diabetes Mellitus and Pre-eclampsia: A Scoping Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Review
- Liraglutide-Driven Weight Loss Modulates Placental Remodeling in Obese Pregnancies in Mice.Cells · 2025Article
- Kidney health outcomes of hypertensive disorders of pregnancy.Nature reviews. Nephrology · 2025Review
- Role of Metformin in Preeclampsia: A Systematic Review.Journal of obstetrics and gynaecology of India · 2025Review
- Evaluating oxidative stress targeting treatments inFrontiers in cell and developmental biology · 2025Article
- Metformin in Gestational Diabetes Mellitus: To Use or Not to Use, That Is the Question.Pharmaceuticals (Basel, Switzerland) · 2023Review
- New Ideas for the Prevention and Treatment of Preeclampsia and Their Molecular Inspirations.International journal of molecular sciences · 2023Review
- Pre-Eclampsia: From Etiology and Molecular Mechanisms to Clinical Tools-A Review of the Literature.Current issues in molecular biology · 2023Review
- A Balancing Act: Navigating Hypertensive Disorders of Pregnancy at Very Advanced Maternal Age, from Preconception to Postpartum.Journal of clinical medicine · 2023Review
- Review
- Preeclampsia: Narrative review for clinical use.Heliyon · 2023Article
- Placental Mitochondrial Function and Dysfunction in Preeclampsia.International journal of molecular sciences · 2023Review
- A placenta-on-a-chip model to determine the regulation of FKBPL and galectin-3 in preeclampsia.Cellular and molecular life sciences : CMLS · 2023Article
- A global view of hypertensive disorders and diabetes mellitus during pregnancy.Nature reviews. Endocrinology · 2022Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
aimsTo perform meta-analyses of studies evaluating the risk of pre-eclampsia in high-risk insulin-resistant women taking metformin prior to, or during pregnancy.
methodsA search was conducted of the Medline, EMBASE, Web of Science and Scopus databases. Both randomized controlled trials and prospective observational cohort studies of metformin treatment vs. placebo/control or insulin either prior to or during pregnancy were selected. The main outcome measure was the incidence of pre-eclampsia in each treatment group.
resultsOverall, in five randomized controlled trials comparing metformin treatment (n = 611) with placebo/control (n = 609), no difference in the risk of pre-eclampsia was found [combined/pooled risk ratio (RR), 0.86 (95% CI 0.33-2.26); P = 0.76; I
conclusionsIn studies randomizing pregnant women to glucose-lowering therapy, metformin was associated with lower gestational weight gain and a lower risk of pre-eclampsia compared with insulin.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.