Review Article

Effect of Metformin Intervention during Pregnancy on the Gestational Diabetes Mellitus in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Table 4

Findings of the trials included in the meta-analysis.

NumberOutcomePCOS with metforminControlsMetformin versus controls

22Second-trimester miscarriage and delivery <gestational week 37 + 0 5/153 18/159 P = 0.008 
Preeclampsia 12/153 7/157P = 0.24 
New gestational diabetes27/14226/141P = 0.90
25GDM 8/200 32/160 P < 0.001, OR = 0.17, 95% CI = 0.07–0.37 
Gestational hypertension and/or preeclampsia 6/20013/160P = 0.03, OR = 0.35, 95% CI = 0.13–0.94 
Caesarean section rate106/20096/160P = 0.18, OR = 0.75, 95% CI = 0.49–1.15
26Preeclampsia 10/135 5/135 P = 0.18, RD = 3.7%, 95% CI = −1.7–9.2 
Preterm delivery 5/135 11/135P = 0.12, RD = −4.4%, 95% CI = −10.1–1.2  
GDM 22/125 21/124P = 0.87, RD = 0.8%, 95% CI = −8.6–10.2 
  RD (risk difference)  
Weight ≤2500 g  8/135 ≤2500 g  8/135 
2501–4500 g 125/135 2501–4500 g 120/135 
>4500 g  2/135 >4500 g  7/135 P = 0.32 
Length of delivery50.3 ± 4.450.0 ± 2.5P = 0.44
27Miscarriage rate9/11923/78P < 0.002
EPL with recurrent miscarriage2/165/11P < 0.001
Gestational diabetes12/11934/780.0021
PIH20/11935/78<0.002
IUGR20/11930/78<0.001
Live birth rate109/11955/78<0.001
28GDM1/299/30OR = 12, 95% CI = 6.20–18.08
Abortion1/291/30
Macrosomia0/294/30
LBW (low birth weight)0/290/30
Birth asphyxia0/295/30
Neonatal death0/291/30
Preterm labor2/293/30
Birth weight2.79 ± 0.1433 ± 0.499P = 0.016
APGAR (5 min)10 ± 009.03 ± 0.326P = 0.006
29Group A Group B Group C
PIH/preeclampsia14/32  6/18  6/458/26P = 0.002
GDM15/32  10/18  13/4512/26P = 0.968
IUGR7/32  3/18  1/455/26P = 0.026
Miscarriage8/40  2/20  0/456/32P = 0.006
Preterm delivery8/32  5/18  2/415/26P = 0.035
Live birth32/40  18/20  45/4526/32P = 0.016
Mean birth weight2.67 ± 0.912.71 ± 0.892.88 ± 0.952.9 ± 1.1P = 0.81
30GDM6/223/18
31GDM6/5019/64
32Preterm deliveries0/185/22
Preeclampsia/hypertension3/182/22
GDM1/183/22
CS (caesarean section)3/184/22
Head circumference36 ± 134 ± 5P = 0.07
Birth weight3595 ± 4203215 ± 1048P = 0.1
Birth length50 ± 248 ± 8P = 0.2
Apgar (5 min)9.3 ± 1.09.5 ± 0.6P = 0.3
Apgar (10 min)9.8 ± 0.79.9 ± 0.2P = 0.3
33SAB (first-trimester spontaneous abortion)12/4662/100McNemar’s = 32, df = 1, P < 0.0001
GDM3/689/34McNemar’s = 5, P = 0.025
34GDM1/3310/37P = 0.0074 (Fisher test)
35GDM2/186/22P = 0.3
Overall pregnancy complications3/1810/22P = 0.09
Severe pregnancy complications0/187/22P = 0.01
36Miscarriage1/317/26P = 0.01
Preterm birth1/312/26P = 0.58
Fatal macrosomia1/311/26P = 1.0
IUGR0/311/26P = 0.45
5 min Apgar score (≤7)1/313/26P = 0.32
Fatal anomalies0/311/26P = 0.45
Neonatal mortality0/311/26P = 0.45
GDM1/316/26