On the potential of metformin to prevent preterm delivery in women with polycystic ovary syndrome – an epi-analysis

Authors

  • ESZTER VANKY,

    1. Department of Obstetrics and Gynecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
    2. Institute for Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
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  • FRANCIS DE ZEGHER,

    1. Pediatric Endocrinology, University Hospital Gasthuisberg, Leuven, Belgium
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  • MARTA DÍAZ,

    1. Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
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  • LOURDES IBÁÑEZ,

    1. Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
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  • SVEN M. CARLSEN

    1. Unit for Applied Clinical Research, Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
    2. Department of Endocrinology, St Olav's Hospital, Trondheim, University Hospital, Trondheim, Norway
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  • Conflicts of interest The authors have stated explicitly that there are no conflicts of interest in connection with this article.

  • Please cite this article as: Vanky E, De Zegher F, Díaz M, Ibáñez L, Carlsen SM. On the potential of metformin to prevent preterm delivery in women with polycystic ovary syndrome – an epi-analysis. Acta Obstet Gynecol Scand. 2012; 91:DOI: 10.1111/aogs.12015.

Eszter Vanky, Department of Obstetrics and Gynecology, St Olav's Hospital, University Hospital of Trondheim, Olav Kyrres gt 16, 7006 Trondheim, Norway. E-mail: eszter.vanky@ntnu.no

Abstract

Our aim was to re-evaluate whether metformin may reduce late miscarriage/preterm delivery, pre-eclampsia and gestational diabetes in women with polycystic ovary syndrome (PCOS). We performed an epi-analysis of two randomized controlled trials. The participants were 313 women aged 18–42 years with PCOS who had singleton pregnancies. They were randomized to metformin or placebo treatment from first trimester until delivery. We analysed the prevalence of late miscarriage/preterm delivery, pre-eclampsia and gestational diabetes according to both the intention-to-treat principle and per protocol analysis. The metformin-treated patients had less late miscarriage/preterm delivery; five (3%) vs. 18 (11%) in the placebo group (p < 0.01). There was no difference in the prevalence of gestational diabetes and pre-eclampsia between the metformin and the placebo group. In this epi-analysis, metformin treatment during pregnancy seems to reduce early delivery in women with PCOS. We believe that further randomized studies should be performed before firm conclusions can be drawn.

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