Metformin for Prevention of Gestational Diabetes in Pregnant Women with Polycystic Ovarian Syndrome: Randomized Controlled Trial (RCT)

Abstract

Polycystic ovary syndrome (PCOS) is heterogeneous endocrine and metabolic disorder with a prevalence between 5-15% in women of reproductive age. Pregnancy in cases with PCOS is associated with several complication including increased prevalence of:spontaneous miscarriage, pregnancy induced hypertension(PIH), placental vascular insufficiency, the birth of small for gestational age(SGA) and gestational diabetes mellitus (GDM). Lifestyle management including diet, exercise and weight loss is recommended as the first line of treatment of women of PCOS.Metformin can be considered in women with PCOS who are already undergoing lifestyle treatment and do not have improvement in impaired glucose tolerance and those who with impaired glucose tolerance. To compare the incidence of gestational diabetes in women who take metformin during pregnancy with those who do not take it.There were no significant differences between women of both groups regarding the initial characteristics age, parity and BMI. Gestational diabetes mellitus incidence was significantly lower in metformin group than placebo group. Antenatal weight gain also was significantly lower in metformin group than placebo group. Regarding gestational hypertension and preeclampsia incidence was lower but not statistically significant. In summing up, we found that significantly lower incidence of GDM and miscarriage in pregnant women with PCOS treated with metformin in pregnancy. Keywords:diabetes mellitus, gestational age, Polycystic ovary syndrome.