دورية أكاديمية
Metformin versus insulin for gestational diabetes: a systematic review and meta-analysis.
| العنوان: | Metformin versus insulin for gestational diabetes: a systematic review and meta-analysis. |
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| المؤلفون: | Bao LX; Affiliated Hospital of Qingdao, University, Qingdao University, Qingdao, People's Republic of China., Shi WT; Affiliated Hospital of Qingdao, University, Qingdao University, Qingdao, People's Republic of China., Han YX; Affiliated Hospital of Qingdao, University, Qingdao University, Qingdao, People's Republic of China. |
| المصدر: | The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2021 Aug; Vol. 34 (16), pp. 2741-2753. Date of Electronic Publication: 2019 Sep 26. |
| نوع المنشور: | Journal Article; Meta-Analysis; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Informa Healthcare Country of Publication: England NLM ID: 101136916 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-4954 (Electronic) Linking ISSN: 14764954 NLM ISO Abbreviation: J Matern Fetal Neonatal Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : Informa Healthcare Original Publication: Boca Raton : Parthenon Pub. Group, c2002- |
| مواضيع طبية MeSH: | Diabetes, Gestational*/drug therapy , Hypoglycemia* , Metformin*/adverse effects, Female ; Humans ; Hypoglycemic Agents/adverse effects ; Infant, Newborn ; Insulin ; Pregnancy |
| مستخلص: | Background: Metformin is increasingly used in clinical practice for the treatment of gestational diabetes mellitus. However, its safety and long-term effects on fetuses exposed to metformin in uterus remain controversial. Methods: We systematically searched PubMed, Embase, and the Cochrane database (last search was updated on 1 May 2019) for randomized controlled trials comparing metformin with insulin. Two reviewers extracted the data and calculated pooled estimates by use of a random-effects model. Results: Twenty-four studies were included. Among these, seventeen RCTs ( N = 2828 participants) were included for quantitative analyses and seven studies were included only for qualitative synthesis. Metformin lowered the risk of pregnancy-induced hypertension ( p = .03; risk ratio (RR) = 0.64; confidence interval (95%CI) [0.44, 0.95]), large for gestational age babies ( p = .04; RR = 0.82; 95% CI [0.68, 0.99]), macrosomia ( p = .01; RR = 0.63; 95%CI [0.45, 0.90]), neonatal hypoglycemia ( p = .001; RR = 0.72; 95%CI [0.59, 0.88]), and neonatal intensive care unit admission ( p = .01; RR = 0.74; 95%CI [0.58, 0.94]). Metformin did not increase premature delivery ( p = .11; RR = 1.28; 95%CI [0.95, 1.73]), preeclampsia ( p = .45; RR = 0.89; 95%CI [0.65, 1.21]), caesarean delivery ( p = .20; RR = 0.94; 95%CI [0.85, 1.04]), small for gestational age babies ( p = .95; RR = 0.99; 95%CI [0.69, 1.42]). The long-term results seemed to have no adverse effect, but the information was still limited. Conclusions: According to our review, metformin may have potential benefits for pregnant women and newborns with no obvious adverse effects. However, even more studies are needed to provide evidence for the future use of metformin. |
| فهرسة مساهمة: | Keywords: Gestational diabetes mellitus; insulin; meta-analysis; metformin; randomized control trials |
| المشرفين على المادة: | 0 (Hypoglycemic Agents) 0 (Insulin) 9100L32L2N (Metformin) |
| تواريخ الأحداث: | Date Created: 20190928 Date Completed: 20210622 Latest Revision: 20220424 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1080/14767058.2019.1670804 |
| PMID: | 31558075 |
| قاعدة البيانات: | MEDLINE |
PDF full text from Publisher | تدمد: | 1476-4954 |
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| DOI: | 10.1080/14767058.2019.1670804 |