Please use this identifier to cite or link to this item: https://hdl.handle.net/10137/7772
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Title: Real-world experience of metformin use in pregnancy: Observational data from the Northern Territory Diabetes in Pregnancy Clinical Register.
Authors: Maple-Brown, Louise J
Lindenmayer, Greta
Barzi, Federica
Whitbread, Cherie
Connors, Christine
Moore, Elizabeth
Boyle, Jacqueline
Kirkwood, Marie
Lee, I-Lynn
Longmore, Danielle
van Dokkum, Paula
Wicks, Mary
Dowden, Michelle
Inglis, Chrissie
Cotter, Margaret
Kirkham, Renae
Corpus, Sumaria
Chitturi, Sridhar
Thomas, Sujatha
O'Dea, Kerin
Zimmet, Paul
Oats, Jeremy
McIntyre, Harold D
Brown, Alex
Shaw, Jonathan E
Citation: Journal of diabetes 2019-09; 11(9): 761-770
Abstract: In Australia's Northern Territory, Indigenous mothers account for 33% of births and have high rates of hyperglycemia in pregnancy. The prevalence of type 2 diabetes (T2D) in pregnancy is up to 10-fold higher in Indigenous than non-Indigenous Australian mothers, and the use of metformin is common. We assessed birth outcomes in relation to metformin use during pregnancy from a clinical register. The study included women with gestational diabetes (GDM), newly diagnosed diabetes in pregnancy (DIP), or pre-existing T2D from 2012 to 2016. Data were analyzed for metformin use in the third trimester. Regression models were adjusted for maternal age, body mass index, parity, and insulin use. Of 1649 pregnancies, 814 (49.4%) were to Indigenous women, of whom 234 (28.7%) had T2D (vs 4.6% non-Indigenous women; P < 0.001). Metformin use was high in Indigenous women (84%-90% T2D, 42%-48% GDM/DIP) and increased over time in non-Indigenous women (43%-100% T2D, 14%-35% GDM/DIP). Among Indigenous women with GDM/DIP, there were no significant differences between groups with and without metformin in cesarean section (51% vs 39%; adjusted odds ratio [aOR] 1.25, 95% confidence interval [CI] 0.87-1.81), large for gestational age (24% vs 13%; aOR 1.5, 95% CI 0.9-2.5), or serious neonatal adverse events (9.4% vs 5.9%; aOR 1.32, 95% CI 0.68-2.57). Metformin use was independently associated with earlier gestational age (37.7 vs 38.5 weeks), but the risk did not remain independently higher after exclusion of women managed with medical nutrition therapy alone, and the increase in births <37 weeks was not significant on multivariate analysis. We found no clear evidence of any adverse outcomes related to the use of metformin for the treatment of hyperglycemia in pregnancy.
Click to open PubMed article: https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/30680949
Click to open Pubmed Article: https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/30680949
Journal title: Journal of diabetes
Publication Date: 2019-09
Type: Journal Article
URI: https://hdl.handle.net/10137/7772
DOI: 10.1111/1753-0407.12905
Appears in Collections:(a) NT Health Research Collection

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