Pregnancy outcomes in normoglycemic women with hyperinsulinemia treated with metformin before and during pregnancy – a case-control study biguanid in pregnancy of hyperinsulinemic women.
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Дата
2010-05
Автори
Todorova – Ananieva, K.
Konova, E.
Iafusco, D.
Palaveev, O.
Emin, Al.
Atanasova, M.
Guenova, M.
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Издател
Централна медицинска библиотека, МУ София / Central Medical Library - MU Sofia
Резюме
The aim of this study was to evaluate the effects of metformin on maternal and neonatal pregnancy outcome among normoglycemic hyperinsulinemic women with one previous spontaneous abortion (SA). A prospective, two-year case-control study was performed including sixty-six pregnant women with normal carbohydrate tolerance before pregnancies and one SA. A 75-gram Oral Glucose Tolerance Test (OGTT) was performed before pregnancy. The levels of blood glucose (BG) and immunoreactive insulin (IRI) were measured at 0 min, 60 min and 120 min. Women with hyperinsulinemia were treated with metformin (0.75 g/day) before and during pregnancy. OGTT was repeated at 12 and 36 gestational weeks (g.w.) in all pregnant women. Pregnant women were divided into two groups: non-treated with metformin (Group 1; n1 = 32) and treated with metformin (Group 2; n2 = 34). The changes in BG, IRI levels during OGTT, live births and SA rates and newborn’s body weight were recorded. Statistical comparison was performed between treated and non-treated pregnant women. Logistical regression analysis was used to assess the effect of hyperinsulinaemia and metformin on the risk of pregnancy loss. No statistically significant differences in the mean values for age, body mass index (BMI) and BG levels were found. The IRI was significantly higher in women of n1 compared to n2 in early and in late pregnancy. Eleven (34.4%) pregnant women of n1 and five (14.7%) of n2 presented impaired glucose tolerance (IGT) at late pregnancy (P=0.03). There was no case of gestational diabetes (GD) in n2, whereas four (12.5%) of n1 developed GD in late pregnancy. There were no maternal complications and no birth defects in the group of patients treated with metformin. The body weight of the newborns was similar for both groups. The rate of miscarriage was 18.7% in Group 1, and 8.8% in Group 2. Pregnant women with IRI levels over 50 mIU/ml at 12 g.w. showed a significantly higher risk for SA in comparison with those with normal level of IRI, proved by the model of logistic regression (OR = 4.9; CI. 2.1-19.3). There was no statistically significant effect of metformin on the logistic regression model. Conclusion of our study was that the treatment with metformin during pregnancy was safe, improved metabolic markers and significantly reduced spontaneous miscarriage rates.
Описание
Address for correspondence:
Katya Todorova – Ananieva MD, PhD
High Risk Pregnancy Department
Specialized Hospital of Obstetrics and Gynecology
2 Zdrave Str.
1431, Sofi a, Bulgaria
tel. 00359 2851 7222
tel. 00359 2851 7222
e-mail: todorova_kate@abv.bg
Ключови думи
hyperinsulinemia, insulin resistance, gestational diabetes, metformin, pregnancy outcome, spontaneous abortion
Цитирания
K. Todorova – Ananieva(1), E. Konova(2), D. Iafusco(3), O. Palaveev(5), Al. Emin(2), M. Atanasova(1) and M. Guenova(4) Pregnancy outcomes in normoglycemic women with hyperinsulinemia treated with metformin before and during pregnancy – a case-control study biguanid in pregnancy of hyperinsulinemic women. - Acta Medica Bulgarica, 37, 2010, № 1, 30-38.