A Comparison of Apgar Scores and Changes in the Neonates of Gestational Diabetes Mellitus Patients Treated with Metformin versus Glyburide: A Systematic Review

Aims: This study aims to compare the Apgar scores (at different time points after birth) and their changes between the newborns of gestational diabetes mellitus (GDM) patients treated with metformin and glyburide, respectively. Methods: Electronic databases were searched for randomized controlled trials that compared these outcomes between the above-depicted intervention groups. The data about the study design, the population characteristics, the interventions compared, and the outcomes of interest were extracted from the eligible trials. Then, these trials were critically appraised by the Cochrane tool. After that, the effect of the tested interventions on the respective outcomes of interest was reported narratively. Results: The literature search produced 4 single-center trials sourcing data from about 538 participants in the USA, Brazil, and Israel. The risk of detection and performance bias was unclear in the respective trials. The trials primarily reported about the Apgar scores at 1 and 5 min after birth. These scores were not different between glyburide- and metformin-treated GDM patients in any trial. No trial reported the Apgar score at 10 min after birth or the changes in Apgar score between 1, 5, or 10 min after birth. Conclusion: In all trials, the Apgar scores at 1 and 5 min after birth did not vary between the newborns of GDM mothers treated with metformin and glyburide, respectively.