Abstract
Metformin is prescribed to women with polycystic ovary syndrome (PCOS) to prevent pregnancy complications. Children exposed to metformin vs. placebo in utero, have increased head circumference at birth and are more overweight and obese at 8 years of age. Also, maternal PCOS-status seems to alter the long-term cardio-metabolic health of offspring. We hypothesized that the long-term effects of metformin-exposure and/or maternal PCOS may be mediated by circulatory adaptations during fetal life. This is a sub-study of a larger double-blinded, placebo-controlled trial, where women with PCOS were randomized to metformin (2g/day) or placebo in pregnancy, a total of 487 women. A sub-group of participants (N = 58) took part in this sub-study and had an extended ultrasound examination at gestational week 32, including blood flow velocity and diameter measurements of the umbilical vein (UV), the ductus venosus (DV) and the portal vein (PV). Blood flow volume was calculated and adjusted for estimated fetal weight (EFW) (normalized flow). Metformin exposed fetuses were compared to placebo exposed fetuses. Fetuses of mothers with PCOS (metformin [n = 30] and placebo [n = 28]) were compared to a low-risk reference population (N = 160) by z-score statistics. There was no difference in fetal liver flow between metformin vs. placebo-exposed fetuses. Fetuses of mothers with PCOS had higher EFW (0.63 [95% CI 0.44-0.83] p<0.001), lower normalized UV, DV, PV, and lower total venous liver blood flows than the reference population. Metformin during pregnancy did not affect fetal liver blood-flow. In our population, maternal PCOS-status was associated with reduced total venous liver blood-flow, which may explain altered growth and metabolism later in life.
Highlights
In unselected populations, nearly 17% of women have polycystic ovary syndrome (PCOS) [1]
There was no difference in fetal liver flow between metformin vs. placebo-exposed fetuses
We found no significant difference in z-scores between PCOS-met and PCOS-plac in any of the venous liver flow parameters (Table 3)
Summary
Nearly 17% of women have polycystic ovary syndrome (PCOS) [1]. Women with PCOS have increased risk of adverse pregnancy outcomes such as gestational diabetes (GDM), preterm delivery, preeclampsia and small for gestational age new-borns [2]. An anti-diabetic drug, is increasingly used to treat both GDM and PCOS. In addition to the liver, metformin affects a variety of organs, such as pancreas, gonads and intestinal microbiota [4, 5]. It prevents late miscarriage and preterm deliveries in mothers with PCOS [6]. Metformin is prescribed to women with polycystic ovary syndrome (PCOS) to prevent pregnancy complications. We hypothesized that the long-term effects of metformin-exposure and/or maternal PCOS may be mediated by circulatory adaptations during fetal life
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
