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Metformin could be a treatment for women with pre-eclampsia

Thursday September 23rd 2021

Metformin shows promise as a treatment for preterm pre-eclampsia, a study reveals today.

Researchers in Australia and South Africa say their findings could have important benefits for both mothers and their babies as it could help to prolong gestation.

Their study, which is published by The BMJ today, reveals that pregnancy was prolonged by a week in the treatment group compared with the no treatment group.

However, the team acknowledges the result was not statistically significant and they have called for further study.

Because preliminary studies suggest metformin could be a potential treatment for pre-eclampsia, the researchers in Australia and South Africa evaluated whether or not extended release metformin could be used to prolong gestation in women with preterm pre-eclampsia.

The trial took place at a large hospital in Cape Town, South Africa, and involved 180 pregnant women undergoing close monitoring for preterm pre-eclampsia between February 2018 and March 2020.

All women were an average of 29 weeks’ pregnant and none had diabetes or were using metformin or other drugs that might interact with it.

Women were randomly split into two groups, with 90 receiving extended release metformin daily and 90 receiving a placebo daily, until they delivered.

The research team found the average time from randomisation to delivery was 17.7 days in the metformin arm and 10.1 days in the placebo arm, but this was not a statistically significant difference.

However, when further analyses were undertaken, they found women who continued to take metformin at any dose showed an average 9.6 day longer gestation, and women who took the full dose of metformin showed an average 11.5 day longer gestation. Both of these results were statistically significant.

There were no differences with serious birth complications or death among both mothers and babies between the two groups and while no serious adverse events were observed, diarrhoea was more common in the metformin group.

The authors acknowledge some limitations to the study - as they focused on a single centre where the women had a high incidence of HIV, obesity, and chronic hypertension, so the results may not be more widely applicable.

However, based on the findings of this study, they write “we are cautiously optimistic that extended release metformin prolongs gestation in women with preterm pre-eclampsia”.

Cluver CA, Hiscock R, Decloedt EH et al. Use of metformin to prolong gestation in preterm pre-eclampsia: randomised, double blind, placebo controlled trial. BMJ 23 September 2021; doi: 10.1136/bmj.n2103

[abstract]

Tags: Africa | Australia | Childbirth and Pregnancy | Diabetes | Pharmaceuticals | Women's Health & Gynaecology

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