Oral Concurrent Session 2 - Diabetes
Oral Concurrent Sessions
.jpg "Maya Patel, BS (she/her/hers) photo")
Ashley N. Battarbee, MD, MSCR
Assistant Professor
University of Alabama at Birmingham
Birmingham, AL, United States
Jerrie Refuerzo, MD
Associate Professor
McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, TX, United States
Noelia Zork, MD
New York Presbyterian, Columbia University Medical Center
New York, New York, United States
Kacey Eichelberger, MD
Chair, Department of Obstetrics & Gynecology
USC School of Medicine Greenville
Greenville, SC, United States
Gladys A. Ramos, MD
Clinica Professor
University of California, San Diego
San Diego, CA, United States
Celeste Durnwald, MD (she/her/hers)
Associate Professor
University of Pennsylvania
Philadelphia, PA, United States
.jpg "Mark B. Landon, MD photo")
Mark B. Landon, MD
Richard L. Meiling Professor and Chair, Obstetrics and Gynecology
The Ohio State University Wexner Medical Center
Columbus, OH, United States
Kjersti M. Aagaard, MD, PhD
Professor and Vice Chair of Research Department of Obstetrics and Gynecology, Division of MFM
Texas Children's Hospital, Baylor College of Medicine
Houston, TX, United States
Todd J. Rosen, MD (he/him/his)
Professor of Obstetrics and Gynecology, Director of Maternal-Fetal Medicine
Robert Wood Johnson Medical School, Rutgers University
New Brunswick, NJ, United States
Amy M. Valent, DO (she/her/hers)
Associate Professor of Obstetrics and Gynecology
Oregon Health & Science University
Portland, OR, United States
Sherri Longo, MD
Maternal-Fetal Medicine Physician
Ochsner Medical center
New Orleans, LA, United States
Pregnant patients with type 2 diabetes (T2DM) are at increased risk of preeclampsia, and both T2DM and preeclampsia increase risk for cardiovascular disease (CVD). Metformin is used to treat T2DM in nonpregnant patients. In addition to hypoglycemic effects, metformin may lower preeclampsia risk in pregnancy and CVD risk in non-pregnant patients. Our objectives were 1) to estimate the association between maternal metformin use for T2DM and preterm preeclampsia, and 2) to measure the effect of metformin use for T2DM in pregnancy on maternal CVD biomarkers.
Study Design:
Secondary analysis of data collected from an RCT comparing the effect of metformin vs placebo on composite neonatal outcome in singleton pregnancies with insulin-treated early diabetes or T2DM. Participants were randomized at 11 - 23 weeks to 1000 mg metformin BID or placebo until delivery. In a subset, maternal blood was collected at 24-30 wks for CVD biomarker measurement. We defined preterm preeclampsia as preeclampsia or HELLP syndrome requiring delivery at < 34 or < 37 wks. We used multivariable regression analysis to estimate the association between metformin use and preterm preeclampsia and maternal CVD biomarker levels.
Results:
Of 831 participants, 119 (14.3%) developed preeclampsia requiring delivery < 37 weeks: 57 (13.7%) of 416 in the placebo group and 62 (14.9%) of 415 in the metformin group. 37 (4.4%) of 831 developed preeclampsia requiring delivery < 34 weeks: 15 (3.6%) of 416 in placebo group and 22 (5.3%) of 415 in metformin group. Metformin did not significantly reduce the odds of early preeclampsia (Table). There was also no association between metformin and maternal soluble endoglin, apolipoprotein B, VCAM-1, or hsCRP level (Table).
Conclusion:
Among pregnant patients with diabetes early in pregnancy or T2DM, the addition of metformin to insulin does not reduce odds of developing preterm preeclampsia or improve maternal serum CVD biomarker measurements in the early third trimester.