{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:57:00Z","timestamp":1792173420211,"version":"4.4.0"},"reference-count":61,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context and Aim<\/jats:title><jats:p>Metformin has been used in pregnancy since the 1970s. It is cheap, widely available and is acceptable to women. Despite its increasing use, controversy remains surrounding its benefits and risks. Metformin effectively reduces hyperglycaemia for the mother during pregnancy and it reduces rates of macrosomia and neonatal hypoglycaemia. However, concern exists surrounding an increase in the rate of SGA births and obesity in childhood. We aim to review the evidence and expert opinion behind metformin in pregnancy through to the post\u2010partum period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a literature review of relevant studies from online databases using a combination of keywords. We also searched the references of retrieved articles for pertinent studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There is strong evidence that metformin is safe in early pregnancy with no risk of congenital malformations. If used throughout pregnancy, it is likely to lead to reduced maternal weight gain and reduced insulin dose in women with type 2 diabetes. In infants, metformin reduces hypoglycaemia and macrosomia but may increase the rate of infants born SGA. There is some evidence of an increased risk of obesity and altered fat distribution in offspring. Metformin appears well tolerated in pregnancy and is more acceptable to women than insulin therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Due to increasing rates of maternal obesity, GDM and type 2 diabetes, metformin use in pregnancy is increasing. Overall, it appears safe and effective but further research is needed to examine mechanisms linking metformin to obesity reported during childhood in some follow\u2010up studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14700","type":"journal-article","created":{"date-parts":[[2021,9,26]],"date-time":"2021-09-26T12:26:24Z","timestamp":1632659184000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Metformin for pregnancy and beyond: the pros and cons"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2387-4109","authenticated-orcid":false,"given":"Christine","family":"Newman","sequence":"first","affiliation":[{"name":"College of Medicine, Nursing and Health Science National University of Ireland  Galway Republic of Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3682-9403","authenticated-orcid":false,"given":"Fidelma P","family":"Dunne","sequence":"additional","affiliation":[{"name":"College of Medicine, Nursing and Health Science National University of Ireland  Galway Republic of Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4343-y"},{"key":"e_1_2_7_3_1","first-page":"dci190066","article-title":"2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"2019","author":"Buse JB","journal-title":"Diabetes Care"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2013.256"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2016.12.009"},{"issue":"20","key":"e_1_2_7_6_1","first-page":"795","article-title":"Pregnancy in established non\u2010insulin\u2010dependent diabetics. A five\u2010and\u2010a\u2010half year study at Groote Schuur Hospital","volume":"58","author":"Coetzee EJ","year":"1980","journal-title":"S Afr Med J"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707193"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30310-7"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ftd.0000184161.52573.0e"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2017-000456"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.5.1390"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30054-X"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2016-000221"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0202183"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30107-3"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1111"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(18)30310-3"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(15)00219-3"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509819"},{"key":"e_1_2_7_20_1","article-title":"Metformin for women who are overweight or obese during pregnancy for improving maternal and infant outcomes","volume":"7","author":"Dodd JM","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-0877"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2006.03.009"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004526"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0853"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30002-6"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042973"},{"key":"e_1_2_7_27_1","article-title":"MeDiGes Study. Metformin versus insulin in gestational diabetes: Glycemic control, and obstetrical and perinatal outcomes. Randomized prospective trial","author":"Molina P\u2010C","year":"2021","journal-title":"Am J Obstet Gynaecol"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02763.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12017"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2012.09.031"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002848"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-036981"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/9804708"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-S014"},{"issue":"8","key":"e_1_2_7_35_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-029808","article-title":"SUGAR\u2010DIP trial: oral medication strategy versus insulin for diabetes in pregnancy, study protocol for a multicentre, open\u2010label, non\u2010inferiority, randomised controlled trial","volume":"9","author":"Wit L","year":"2019","journal-title":"BMJ Open"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.108685"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30406-X"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098618769831"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/325851"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1326994"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.11.043"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2016.127"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1361"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0772"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3761"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13481"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1124\/mol.118.112482"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2451"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k2477"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmu022"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmu037"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00441-016-2496-5"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0660"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12964"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2012.712319"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2017-000456"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-02419"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(18)30385-7"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-020-1960-2"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40142-013-0014-6"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05123-6"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-4935-9"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.14700","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.14700","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.14700","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T12:03:02Z","timestamp":1692964982000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.14700"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,7]]},"references-count":61,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1111\/dme.14700"],"URL":"https:\/\/doi.org\/10.1111\/dme.14700","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,7]]},"assertion":[{"value":"2021-07-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14700"}}