Metformin use in PCOS pregnancies increases the risk of offspring overweight at 4 years of age; follow-up of two RCTs.

Metformin use in PCOS pregnancies increases the risk of offspring overweight at 4 years of age; follow-up of two RCTs.

J Clin Endocrinol Metab. 2018 Feb 27;:

Authors: Engen Hanem LG, Stridsklev S, Júlíusson PB, Salvesen Ø, Roelants M, Carlsen SM, Ødegård R, Vanky E

Abstract
Context: Metformin is used in pregnancy in women with gestational diabetes mellitus, polycystic ovary syndrome (PCOS) and obesity. Metformin passes the placenta.
Objective: To explore the effects of metformin use in PCOS pregnancies on offspring growth to 4 years of age.
Design: Follow-up study of two randomized, double blind, placebo-controlled trials.
Setting: Secondary care centers. Eleven public hospitals in Norway.
Participants: 182 children of mothers with PCOS who participated in two RCTs.
Intervention: Metformin 1700 or 2000 mg daily or placebo from 1st trimester to delivery in the original studies. No intervention in the present study.
Main outcome measures: Height, weight, body mass index (BMI) and overweight/obesity at 4 years of age, and head circumference at 1 year of age, converted to z-scores.
Results: The difference in height z-score means between the groups at 4 years of age was non-significant (95% CI): 0.07 (-0.22 to 0.36), p=0.651. At 4 years of age, the metformin group had higher weight z-score than the placebo group; difference in means 0.38 (0.07 to 0.69), p=0.017, and higher BMI z-score; difference in means 0.45 (0.11 to 0.78), p=0.010. There were more overweight/obese children in the metformin group; 26 (32%) than in the placebo group; 14 (18%) at 4 years of age; odds ratio (95% CI): 2.17 (1.04 to 4.61), p=0.038. The difference in mean head circumference z-score at 1 year of age was: 0.27 (-0.04 to 0.58), p=0.093.
Conclusion: Metformin exposed children had higher BMI and increased prevalence of overweight/obesity at 4 years of age.

PMID: 29490031 [PubMed - as supplied by publisher]

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