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Metformin use in pregnancy: promises and uncertainties
Metformin has been prescribed in pregnancy for over 40 years; for much of this time, use has been limited both in numbers and geographically, and the evidence base has been confined to observational studies. In early years, perceived safety concerns and lack of availability of the drug in many count...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5552827/ https://www.ncbi.nlm.nih.gov/pubmed/28770325 http://dx.doi.org/10.1007/s00125-017-4351-y |
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author | Lindsay, Robert S. Loeken, Mary R. |
author_facet | Lindsay, Robert S. Loeken, Mary R. |
author_sort | Lindsay, Robert S. |
collection | PubMed |
description | Metformin has been prescribed in pregnancy for over 40 years; for much of this time, use has been limited both in numbers and geographically, and the evidence base has been confined to observational studies. In early years, perceived safety concerns and lack of availability of the drug in many countries acted as a barrier to use. More recently, RCTs have begun to examine the role of metformin in pregnancy in much-needed detail. However, this evidence base has been interpreted differently in different countries, leading to very wide variation in its current application in pregnancy. In this short review, we will discuss the history of metformin in pregnancy and highlight some of the key clinical trials. We will then consider some of the remaining controversies associated with metformin use in pregnancy, most important of these being the potential for long-term ‘programming’ effects on the fetus as a result of metformin being able to cross the placenta. We will also consider clinical situations where metformin might be avoided. Finally, we will discuss some future directions for this drug as it reaches its sixtieth anniversary. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00125-017-4351-y) contains a slide of the figure for download, which is available to authorised users. |
format | Online Article Text |
id | pubmed-5552827 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-55528272017-08-25 Metformin use in pregnancy: promises and uncertainties Lindsay, Robert S. Loeken, Mary R. Diabetologia Review Metformin has been prescribed in pregnancy for over 40 years; for much of this time, use has been limited both in numbers and geographically, and the evidence base has been confined to observational studies. In early years, perceived safety concerns and lack of availability of the drug in many countries acted as a barrier to use. More recently, RCTs have begun to examine the role of metformin in pregnancy in much-needed detail. However, this evidence base has been interpreted differently in different countries, leading to very wide variation in its current application in pregnancy. In this short review, we will discuss the history of metformin in pregnancy and highlight some of the key clinical trials. We will then consider some of the remaining controversies associated with metformin use in pregnancy, most important of these being the potential for long-term ‘programming’ effects on the fetus as a result of metformin being able to cross the placenta. We will also consider clinical situations where metformin might be avoided. Finally, we will discuss some future directions for this drug as it reaches its sixtieth anniversary. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00125-017-4351-y) contains a slide of the figure for download, which is available to authorised users. Springer Berlin Heidelberg 2017-08-02 2017 /pmc/articles/PMC5552827/ /pubmed/28770325 http://dx.doi.org/10.1007/s00125-017-4351-y Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Review Lindsay, Robert S. Loeken, Mary R. Metformin use in pregnancy: promises and uncertainties |
title | Metformin use in pregnancy: promises and uncertainties |
title_full | Metformin use in pregnancy: promises and uncertainties |
title_fullStr | Metformin use in pregnancy: promises and uncertainties |
title_full_unstemmed | Metformin use in pregnancy: promises and uncertainties |
title_short | Metformin use in pregnancy: promises and uncertainties |
title_sort | metformin use in pregnancy: promises and uncertainties |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5552827/ https://www.ncbi.nlm.nih.gov/pubmed/28770325 http://dx.doi.org/10.1007/s00125-017-4351-y |
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