A narrative review of metformin in pregnancy: Navigating benefit and uncertainty

McEvoy, Robert P., Newman, Christine, Egan, Aoife M., & Dunne, Fidelma P. . (2025). A narrative review of metformin in pregnancy: Navigating benefit and uncertainty. Diabetes, Obesity and Metabolism. https://doi.org/10.1111/dom.16361

Abstract

Metformin is well-established as a treatment for type 2 diabetes in non-pregnant individuals. The low cost, acceptability and broad tolerability of metformin have also made it an attractive option for research into the treatment of other conditions associated with insulin resistance. Despite almost 50 years of clinical experience with the use of metformin to treat diabetes in pregnancy, many questions remain regarding its precise effectiveness in different maternal subgroups, as well as potential short-term and long-term effects on the offspring. In this narrative review, we present the current evidence for the use of metformin during pregnancy in various maternal subgroups, including women living with overweight and obesity, women at risk of gestational diabetes, women diagnosed with gestational diabetes, and women with pregestational diabetes, including type 2 diabetes. Our specific focus is on the impact of metformin on short-term maternal, foetal and neonatal outcomes. We also consider the evidence for other emerging indications for metformin in pregnancy, such as the prevention and management of pre-eclampsia.

Funder

Merck

Publisher

Wiley

Rights

Attribution-NonCommercial-NoDerivatives 4.0 International

cbn

Collections

Medicine (Scholarly Articles)