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Oral hypoglycemic agents in pregnancy
Nam D Tran1, Stephen K Hunter, Jerome Yankowitz
1Department of Obstetrics and Gynecology, University of California-San Francisco, San Francisco, California, USA.
Obstetrical & Gynecological Survey
|May 29, 2004
Summary
Oral hypoglycemic agents are increasingly used for pregnant women with diabetes. This review examines their safety, efficacy, and controversies during pregnancy.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Pharmacology
Background:
- Pregnancy in women with diabetes mellitus (DM) increases risks for spontaneous abortion, congenital malformations, and other adverse outcomes.
- Historically, oral hypoglycemic agents (OHAs) were contraindicated in pregnancy due to concerns about teratogenicity and fetal hypoglycemia.
- Recent trends show increased prescription of newer OHA generations for gestational diabetes mellitus (GDM) and type II DM in pregnant patients.
Purpose of the Study:
- To review the mechanisms of action of various oral hypoglycemic agents.
- To list known side effects of these agents.
- To summarize current data on OHA use in pregnancy.
Main Methods:
- Literature review of studies on oral hypoglycemic agents in pregnancy.
- Analysis of safety data, efficacy, and current recommendations.
- Discussion of controversies surrounding OHA use in pregnant diabetic patients.
Main Results:
- Advances in antepartum care and strict glycemic control (diet, insulin) reduce maternal and perinatal complications.
- Newer oral hypoglycemic agents are being prescribed more frequently for GDM and type II DM in pregnancy.
- Evidence on the safety and efficacy of these newer agents is still evolving.
Conclusions:
- The use of oral hypoglycemic agents in pregnancy requires careful consideration of risks and benefits.
- Further research is needed to establish definitive safety and efficacy profiles for newer agents.
- Clinicians must weigh current evidence and guidelines when prescribing OHAs for diabetic pregnancies.