Early gestational diabetes mellitus and the effect of metformin use on perinatal outcomes: a systematic review.

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Minerva obstetrics and gynecology Pub Date : 2025-03-21 DOI:10.23736/S2724-606X.25.05591-5

Gianna Wilkie, Allison Payne, Becky Baltich Nelson, Anna R Whelan

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Abstract

Introduction: The objective of this study was to perform a systematic review to assess whether metformin therapy in patients diagnosed with gestational diabetes mellitus (GDM) in early pregnancy is associated with improved perinatal outcomes. We searched Ovid MEDLINE, Scopus, and Cochrane library (inclusive of ClinicalTrials.gov) from inception through November 29, 2023. We included all randomized trials that assessed metformin use in early GDM.

Evidence acquisition: The 3665 results produced from the database searches were imported into Covidence, a systematic review screening tool, and duplicates were removed. The remaining 2731 citations were screened by title and abstract against predetermined inclusion and exclusion criteria by 2 independent reviewers with discrepancies resolved after group discussion. After screening was completed, 46 studies underwent full text review, with 1 study eligible for inclusion.

Evidence synthesis: The included study showed no difference in a composite adverse perinatal outcome between those diagnosed with early GDM and treated with metformin (59.3%) vs. placebo (57.1%).

Conclusions: There is a paucity of data regarding the management of early GDM and the lack of standardization in its definition for this condition.

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早期妊娠糖尿病和二甲双胍对围产期结局的影响：系统性综述。

简介本研究旨在进行一项系统性综述，以评估对妊娠早期诊断为妊娠糖尿病（GDM）的患者进行二甲双胍治疗是否与围产期结局的改善相关。我们检索了从开始到 2023 年 11 月 29 日的 Ovid MEDLINE、Scopus 和 Cochrane 图书馆（包括 ClinicalTrials.gov）。我们纳入了所有评估早期 GDM 使用二甲双胍的随机试验：我们将数据库检索得到的 3665 项结果导入系统综述筛选工具 Covidence，并删除了重复的内容。剩余的 2731 篇引文由 2 位独立审稿人根据预先确定的纳入和排除标准按标题和摘要进行筛选，不一致之处经小组讨论后解决。筛选结束后，对 46 项研究进行了全文审阅，其中 1 项研究符合纳入条件：纳入的研究显示，早期 GDM 患者接受二甲双胍治疗的比例（59.3%）与接受安慰剂治疗的比例（57.1%）在围产期综合不良结局方面没有差异：结论：有关早期 GDM 管理的数据极少，对这种情况的定义也缺乏标准化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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