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Can Metformin Reduce Weight Gain In Pregnancy?


sharma-obesity-pregnancy5Excessive weight gain during pregnancy is a well-established risk factor for both mother and child.

Now a paper by Argyro Syngelaki and colleagues from the UK, published in the New England Journal of Medicine, suggests that the anti-diabetes drug metformin may limit weight gain in pregnant non-diabetic women with obesity and also reduce the incidence of pre-eclampsia.

The researchers randomised 450 pregnant women with a BMI greater than 35 and no diabetes to either metformin (3 g/day) or placebo from weeks 12-18 weeks of gestation till delivery in a double-blind fashion.

Among the 400 women who completed the study, those on metformin gained about 2 Kg less weight than the placebo group.

There was also an almost 75% decrease in the risk of developing preeclampsia.

Despite these effects, metformin did not significantly reduce the incidence of large-for-gestational-age babies or other adverse neonatal outcomes.

While these findings may be somewhat disappointing with regard to outcomes in the offspring, the reduction in pre-eclampsia is impressive and, if confirmed, could well be an interesting use of this compound in high-risk pregnancies.

@DrSharma
Kelowna, BC

3 Comments

  1. Midwife in uk for 35 years what we have failed to address is the change to the western diet and frequency that we eat meals and snacks. The majority of the population are carbohydrate
    Intolerant. We are not testing for hyperinsulinemia in pregnancy just random blood stugars and GTT witch fail to pick up most cases in women yet if they are over weight or obese they will be in this group see Dr Joseph Kraft work.
    In the old days we weighed women and advised about weight gain of around 25lb in pregnancy but NICE stopped that.
    The management of gestational diabetics and diabetics is eat carbs till they come out of your ears not to keep the blood sugars low enough and use insulin.I had a lady with BMI of over 60 who bless her did what I said baby 7lb 8 LSCS no surgical site infection same time diabetic team with bigger girl
    SB 12lb+ SB at section.
    We need to give these women the correct information and help with much lower carbohydrate
    Intake and real food not eat less exercise more nonsense that dose not work,don’t eat for six and don’t forget what she is drinking. I have a hunch that hyperinsulinemia may contribute to the cause of some of our SB insulin inflames blood vessels.
    How sad to lose a baby that could have lived by changing diet, we need to re educate HCP
    In dietary advise to our patients.

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  2. Great new data. Metformin seems to have implications above and beyond weight. We are looking at metformin in patients with mental health disorders in hopes of decreasing metabolic conditions that arise with the use of psychiatric medicaitons. Interesting work.

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  3. They started Metformin after the first trimester. That is why it dod not reduce the incidence of large-for-gestational-age babies or other adverse neonatal outcomes.
    It makes the other results even more impressive.

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