{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T05:47:25Z","timestamp":1695620845596},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,4,22]],"date-time":"2015-04-22T00:00:00Z","timestamp":1429660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Glycaemic control in women with gestational diabetes mellitus (<jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>) has typically been achieved with diet, exercise and insulin therapy. Controversy exists in the literature about a potential role for metformin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature review was completed aiming to compare the glycaemic control, maternal and fetal out comes of metformin therapy with insulin. Searches were completed on databases, including <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>edline, <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>ub<jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ed and <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>cience<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>irect. Seven randomised control trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) fit the inclusion criteria, with a total sample size of 1514 women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of studies found no difference in glycaemic control between metformin and insulin groups. When comparing maternal outcomes, those receiving metformin therapy recorded less maternal weight gain in four studies. A\u00a0number of studies reported lower rates of neonatal hypoglycaemia, and one reported higher rates of preterm birth in the metformin group. There were no other differences in the recorded maternal and fetal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>adad score for assessing risk of bias for most included studies was either 3 or 4. The criteria for diagnosis of <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>, maternal and neonatal complications varied between studies. Only one study has published follow\u2010up data, and most are single\u2010centre trials with relatively small sample sizes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Though there is a growing body of evidence to suggest a role for metformin in <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> management, further large\u2010scale, multicentre <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s are needed before guidelines can be altered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12311","type":"journal-article","created":{"date-parts":[[2015,4,23]],"date-time":"2015-04-23T03:28:58Z","timestamp":1429759738000},"page":"303-308","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Metformin for the management of gestational diabetes mellitus"],"prefix":"10.1111","volume":"55","author":[{"given":"Kamal P.","family":"Singh","sequence":"first","affiliation":[{"name":"School of Public Health and Community Medicine University of New South Wales Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhad","family":"Rahimpanah","sequence":"additional","affiliation":[{"name":"Liverpool Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margot","family":"Barclay","sequence":"additional","affiliation":[{"name":"Liverpool Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,4,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-S011"},{"key":"e_1_2_6_3_1","unstructured":"Diabetes Australia.Gestational Diabetes; Canberra 2014. 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