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Maternal body mass index (BMI), offspring BMI <jats:italic>z<\/jats:italic>\u2010score and maternal infections were evaluated as effect modifiers or mediators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Incidence of maternal infections during pregnancy, delivery, and postpartum, and allergic diseases in offspring at 8\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Altogether 634 women and 145 offspring were included. Women treated with metformin experienced fewer overall infections during pregnancy (OR\u2009=\u20090.68, 95% CI: 0.50\u20130.93), particularly viral infections (OR\u2009=\u20090.71, 95% CI: 0.51\u20130.99). Offspring exposed to metformin in utero had a higher incidence of allergies (OR\u2009=\u20094.83, 95% CI: 1.47\u201321.8) and eczema (OR\u2009=\u20092.42, 95% CI: 1.14\u20135.33). Maternal BMI did not modify the effect of metformin, and offspring BMI <jats:italic>z<\/jats:italic>\u2010score or maternal infections did not mediate the relationship between metformin treatment and increased allergies and eczema in offspring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Metformin treatment in pregnant women with PCOS reduced maternal infections during pregnancy and increased the incidence of allergies and eczema in offspring at 8\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> identifiers: NCT03259919, NCT00159536 and NCT01587378<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18320","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T07:17:34Z","timestamp":1754896654000},"page":"1823-1832","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Metformin Treatment in <scp>PCOS<\/scp> Pregnancies Reduces Maternal Infections and Increases the Risk of Allergies and Eczema in the Offspring: Post Hoc Analyses of Two Randomised Controlled Trials and One Follow\u2010Up Study"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4961-214X","authenticated-orcid":false,"given":"Mariell","family":"Ryssdal","sequence":"first","affiliation":[{"name":"Department of Clinical and Molecular Medicine Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanne 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