The administration of metformin during pregnancy reduces polycystic ovary syndrome related gestational complications

OBJECTIVES: To prospectively evaluate the safety of metformin administration during pregnancy in a group of PCOS patients by assessing its effect on the prevalence of gestational complications and neonatal outcome. STUDY DESIGN: Our prospective, single centre study included 98 pregnant women with PCOS treated with metformin throughout pregnancy and 110 normal pregnant controls. All PCOS patients were hyperinsulinemic and received metformin (1700-3000 mg/day) before conception and until 37 weeks' gestation. RESULTS: Metformin treatment in the pregnant PCOS patients resulted in significant decrease in miscarriage rate (9.1% vs 20%; p<0.05), gestational diabetes (0 vs 13%; p<0.005), and gestational hypertension (0 vs 11%; p<0.005) and a non-significant decrease in pre-eclampsia (0 vs 3%; p=.24), compared to the control group. Mean neonatal Apgar score, weight and length were comparable between the two groups. CONCLUSIONS: Continuing metformin therapy throughout pregnancy resulted in significant reduction in pregnancy complications with concomitant improved neonatal outcome, with no serious deleterious side effects.