Neonatal Outcomes in Patients with Gestational Diabetes Mellitus Treated with Metformin: A Retrospective Study in Saudi Arabia

TL;DR

This study in Saudi Arabia found that metformin is a safe treatment for gestational diabetes during pregnancy, with similar neonatal outcomes to insulin.

Contribution

The study evaluates metformin's safety in Saudi patients with gestational diabetes, comparing neonatal outcomes to insulin and diet.

Findings

Metformin and insulin groups had similar neonatal outcomes.

Metformin increased risks of hypoglycemia and hyperbilirubinemia in newborns compared to diet.

Metformin slightly reduced APGAR scores compared to diet alone.

Abstract

Background: Gestational diabetes mellitus (GDM) is a common endocrine disease that can occur during pregnancy, increasing the risk of fetal morbidity and mortality. Metformin is a commonly used therapeutic approach for managing GDM. However, there is controversy regarding the effects of metformin on fetal outcomes during pregnancy. This study aimed to evaluate the safety of metformin in relation to neonatal complications, compared to treatment with insulin and/or specialized diets. Method: This was a retrospective study that included pregnant women who were diagnosed with GDM and treated with specialized diets, metformin, or insulin. Data were collected from patients’ electronic medical records and analyzed to evaluate the risk of neonatal outcomes in the metformin group compared to the others. Results: The study included 234 women with GDM. There was no difference between the metformin and insulin groups in terms of the rates of neonatal outcomes, while neonatal hypoglycemia, neonatal hyperbilirubinemia, large for gestational age, and respiratory distress were higher in the metformin group when compared to the diet group. Metformin slightly increased the risk of a lower APGAR score compared to diet alone. Conclusions: Metformin was found to be a safe therapy for the fetus when used to manage GDM, compared to insulin therapy. More randomized studies are needed to confirm these findings in the Saudi population.