ArticleBMJ open diabetes research & care2022
Metformin in pregnancy and risk of abnormal growth outcomes at birth: a register-based cohort study.
Article in BMJ open diabetes research & care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- Metformin use in gestational diabetes mellitus and neonatal outcomes: a systematic review and meta-analysis on the risk of small for gestational age.Frontiers in medicine · 2025Pooled it
- Metformin Exposure in Pregnancy and Fetal Programming: A Focused Review of Contemporary Evidence.Biomedicines · 2026Review
- Metformin use in gestational diabetes is not associated with an increased risk of preterm labor and small for gestational age infants compared to diet control alone.BMC pregnancy and childbirth · 2025Article
- Effect of in utero metformin exposure in gestational diabetes mellitus on infant mesenchymal stem cell metabolism.American journal of physiology. Endocrinology and metabolism · 2025Article
- Decreased Liver Kinase B1 Expression and Impaired Angiogenesis in a Murine Model of Bronchopulmonary Dysplasia.American journal of respiratory cell and molecular biology · 2024Article
- Neonatal outcome following metformin-treated gestational diabetes mellitus: A population-based cohort study.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Update on the therapeutic role of metformin in the management of polycystic ovary syndrome: Effects on pathophysiologic process and fertility outcomes.Women's health (London, England)Review
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWe previously reported an increased risk of being small for gestational age (SGA) and a decreased risk of being large for gestational age (LGA) after in utero exposure to metformin compared with insulin exposure. This follow-up study investigated if these observations remain when metformin exposure (henceforth, metformin cohort) is compared with non-pharmacological antidiabetic treatment of gestational diabetes mellitus (GDM; naïve cohort), instead of insulin. RESEARCH DESIGN AND
methodsThis was a Finnish population register-based cohort study from singleton children born during 2004-2016. Birth outcomes from metformin cohort (n=3964) and the naïve cohort (n=82 675) were used in the main analyses. Additional analyses were conducted in a subcohort, restricting the metformin cohort to children of mothers with GDM only (n=2361). Results were reported as inverse probability of treatment weighted OR (wOR), with the naïve cohort as reference.
resultsNo difference was found for the outcome of SGA between the cohorts in the main analyses (wOR 0.97, 95% CI 0.73 to 1.27) or in the additional analyses (wOR 1.01, 95% CI 0.75 to 1.37). No difference between the cohorts was found for the risk of LGA (wOR 0.91, 95% CI 0.75 to 1.11) in the main analyses but a decreased risk was observed in the additional analyses (wOR 0.72, 95% CI 0.56 to 0.92).
conclusionsThis follow-up study found no increase in the risk of SGA or LGA after in utero exposure to metformin, compared with drug-naïve GDM. The decreased risk of LGA in mothers with GDM may suggest residual confounding. The lack of increased SGA risk aligns with findings from studies using metformin in non-diabetic pregnancies. In contrast, lower birth weight and increased SGA birth risk were observed in GDM pregnancies for metformin versus insulin. Metformin should be avoided with emerging growth restriction in utero. The interplay of intrauterine hyperglycemia and pharmacological treatments needs further assessment.
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