{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:28:45Z","timestamp":1790116125736,"version":"4.0.1"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Metformin is the first\u2010line drug for the treatment of Type 2 diabetes. In 2022, a Danish registry\u2010based study reported a 40% increased risk of major congenital malformations following paternal exposure during spermatogenesis. This raised widespread concern about the use of metformin in males of reproductive age. Three subsequent studies were unable to replicate this finding. We performed a meta\u2010analysis of four observational studies with data from five countries covering more than 11\u2009000 live\u2010born children whose fathers used metformin during spermatogenesis. The pooled risk ratio from an inverse variance\u2010weighted random effects model was 1.03 (95% CI 0.88\u20131.21). We conclude that paternal exposure to metformin does not confer a meaningfully increased risk of major congenital malformations.<\/jats:p>","DOI":"10.1002\/bcp.70547","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T07:00:09Z","timestamp":1775458809000},"page":"1940-1943","source":"Crossref","is-referenced-by-count":2,"title":["Paternal use of metformin and risk of major congenital malformations: A meta\u2010analysis of 4 studies"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0591-7187","authenticated-orcid":false,"given":"Per","family":"Damkier","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4853-4434","authenticated-orcid":false,"given":"Marleen M. H. 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Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology Odense University Hospital  Odense Denmark"},{"name":"Research Unit of Clinical Epidemiology, Department of Clinical Research University of Southern Denmark  Odense C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-3033","authenticated-orcid":false,"given":"Bente M.","family":"N\u00f8rg\u00e5rd","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology Odense University Hospital  Odense Denmark"},{"name":"Research Unit of Clinical Epidemiology, Department of Clinical Research University of Southern Denmark  Odense C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hedvig","family":"Nordeng","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010022\u201005787\u20102"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/M21\u20104389"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izac038"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11216595"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/M23\u20101405"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.15002"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102024\u2010080127"},{"key":"e_1_2_9_9_1","unstructured":"Cochrane Handbook for Systematic Reviews of Interventions|Cochrane. 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