Appropriate use of metformin in early pregnancy: is there a role for first trimester use?

    February 2013
    Dimitrios Panidis, Konstantinos Tziomalos
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    TLDR Metformin is safe in early pregnancy for women with PCOS and may reduce certain risks.
    The document from 2013 reviews the use of metformin in early pregnancy for women with polycystic ovary syndrome (PCOS), focusing on its potential to reduce risks such as gestational diabetes, hypertensive disorders, and preterm delivery. Metformin is shown to be well-tolerated with high adherence rates among pregnant women and a low discontinuation rate due to side effects. Clinical trials and meta-analyses support its safety, indicating no increase in congenital abnormalities or neonatal mortality. A specific trial highlighted increased pregnancy and live birth rates in women with PCOS using metformin. The document suggests possible long-term benefits for children of metformin-treated mothers, like reduced insulin resistance, but calls for more research to confirm these findings. The consensus statement on metformin use in PCOS during pregnancy may need updating in light of new evidence supporting its benefits.
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