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Oral hypoglycaemic agents in 118 diabetic pregnancies
E Hellmuth1, P Damm, L Mølsted-Pedersen
1Department of Obstetrics and Gynaecology, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Denmark.
Diabetic Medicine : a Journal of the British Diabetic Association
|September 6, 2000
Summary
Metformin use in pregnant women with diabetes increased pre-eclampsia and perinatal mortality. Oral hypoglycaemic agents require careful consideration for maternal and neonatal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Perinatology
- Endocrinology
Background:
- Gestational diabetes and pre-existing diabetes in pregnancy present risks.
- Oral hypoglycaemic agents are increasingly used for glycemic control during pregnancy.
- Evaluating the safety of oral hypoglycaemic agents in pregnancy is crucial.
Purpose of the Study:
- To assess maternal and neonatal complications in diabetic pregnancies treated with oral hypoglycaemic agents.
- To compare outcomes between metformin, sulphonylurea, and insulin treatments.
Main Methods:
- A cohort study of orally treated pregnant diabetic patients.
- Compared 50 women on metformin, 68 on sulphonylurea, and 42 on insulin.
- Outcomes assessed included pre-eclampsia, neonatal morbidity, and perinatal mortality.
Main Results:
- Metformin use was associated with a significantly higher prevalence of pre-eclampsia (32%) compared to sulphonylurea (7%) or insulin (10%).
- No significant difference in neonatal morbidity was observed between oral agents and insulin.
- Metformin use in the third trimester showed a significantly increased perinatal mortality (11.6%) versus non-metformin users (1.3%).
Conclusions:
- Metformin treatment during pregnancy is linked to increased pre-eclampsia.
- Metformin use in late pregnancy is associated with higher perinatal mortality.
- Careful consideration of metformin's risks is warranted in diabetic pregnancies.