{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:25:01Z","timestamp":1791419101218,"version":"4.3.3"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,6,8]],"date-time":"2016-06-08T00:00:00Z","timestamp":1465344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2017,1]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n To assess the short\u2010 and long\u2010term maternal and fetal impact of metformin in pregnancy compared with insulin.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We performed a comprehensive literature search of\n MEDLINE<\/jats:styled-content>\n ,\n EMBASE<\/jats:styled-content>\n ,\n BIOSIS<\/jats:styled-content>\n , Cochrane Database of Systematic Reviews and ClinicalTrials.gov. Eligible studies were randomized control trials (\n RCT<\/jats:styled-content>\n s) or follow\u2010up of an\n RCT<\/jats:styled-content>\n that: (1) compared metformin with insulin in pregnancy in women with gestational diabetes mellitus or Type 2 diabetes; and (2) reported maternal or fetal outcomes of interest. Two reviewers extracted the data, evaluated study quality and calculated pooled estimates.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Sixteen studies (\n n<\/jats:italic>\n = 2165 in quantitative analysis) were included. Metformin lowered the risk of neonatal hypoglycaemia [risk ratio (\n RR<\/jats:styled-content>\n ) = 0.63; 95% confidence interval (95%\n CI<\/jats:styled-content>\n ), 0.45 to 0.87], large for gestational age babies (\n RR<\/jats:styled-content>\n = 0.80; 95%\n CI<\/jats:styled-content>\n , 0.64 to 0.99), pregnancy\u2010induced hypertension (\n RR<\/jats:styled-content>\n = 0.56; 95%\n CI<\/jats:styled-content>\n , 0.37 to 0.85) and total maternal pregnancy weight gain [mean difference (\n MD<\/jats:styled-content>\n ) \u20132.07; 95%\n CI<\/jats:styled-content>\n \u20132.88 to \u20131.27]. Metformin did not increase preterm delivery (\n RR<\/jats:styled-content>\n = 1.18; 95%\n CI<\/jats:styled-content>\n 0.67 to 2.07), small for gestational age babies (\n RR<\/jats:styled-content>\n = 1.20; 95%\n CI<\/jats:styled-content>\n , 0.67 to 2.14), perinatal mortality (\n RR<\/jats:styled-content>\n = 0.82; 95%\n CI<\/jats:styled-content>\n , 0.17 to 3.92) or Caesarean section (\n RR<\/jats:styled-content>\n = 0.97; 95%\n CI<\/jats:styled-content>\n , 0.80 to 1.19). Long\u2010term outcome information is limited.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our review found that metformin had no short\u2010term adverse effects on pregnancy, potential benefits in the neonatal period, but limited long\u2010term follow\u2010up information. Prior to routine use, we recommend further follow\u2010up studies of offspring exposed to metformin\n in utero<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dme.13150","type":"journal-article","created":{"date-parts":[[2016,5,6]],"date-time":"2016-05-06T06:52:52Z","timestamp":1462517572000},"page":"27-36","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":139,"title":["Short\u2010 and long\u2010term outcomes of metformin compared with insulin alone in pregnancy: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"34","author":[{"given":"S.","family":"Butalia","sequence":"first","affiliation":[{"name":"Department of Medicine University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine St Joseph's Hospital Comox British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Lodha","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics & Community Health Sciences University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Aitken","sequence":"additional","affiliation":[{"name":"Knowledge Resource Service Alberta Health Services Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Zakariasen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Calgary Calgary Alberta Canada"},{"name":"Department of Obstetrics and Gynecology University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1K045"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707193"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h102"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.advms.2014.03.001"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2014.10.001"},{"key":"e_1_2_8_8_1","first-page":"970","article-title":"Neonatal outcomes in women with gestational diabetes mellitus treated with metformin in compare with insulin: a randomized clinical trial","volume":"19","author":"Ruholamin S","year":"2014","journal-title":"J Res Med Sci"},{"key":"e_1_2_8_9_1","first-page":"163","article-title":"A pilot randomized, controlled trial of metformin versus insulin in women with type 2 diabetes mellitus during pregnancy","volume":"30","author":"Refuerzo JS","year":"2015","journal-title":"Am J Perinatol"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0660"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7392.762\/a"},{"key":"e_1_2_8_12_1","first-page":"1011","article-title":"Metformin and insulin in the management of gestational diabetes mellitus: preliminary results of a comparison","volume":"52","author":"Moore L","year":"2007","journal-title":"J Reprod Med"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02763.x"},{"key":"e_1_2_8_14_1","first-page":"384","article-title":"Metformin prevents macrosomia and neonatal morbidity in gestational diabetes","volume":"28","author":"Hassan J","year":"2012","journal-title":"Pak J Med Sci"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2012.09.031"},{"key":"e_1_2_8_16_1","first-page":"327","article-title":"Comparison of newborn outcomes in women with gestational diabetes mellitus treated with metformin or insulin: a randomised blinded trial","volume":"4","author":"Mesdaghinia E","year":"2013","journal-title":"Int J Prevent Med"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.03.022"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12017"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1326994"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-3090-7"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12964"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0064585"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3566-0"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03361.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-2-201307160-00661"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.09.007"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0082310"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.05.001"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.74"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0346"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2012.712319"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh347"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3965"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0853"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13150","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13150","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T21:56:21Z","timestamp":1696283781000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.13150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,8]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1111\/dme.13150"],"URL":"https:\/\/doi.org\/10.1111\/dme.13150","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.726338159.793559268","asserted-by":"object"}]},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,8]]},"assertion":[{"value":"2016-05-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-06-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}