Evidence mapPaperPMID 39042587Full record

ArticleDiabetes care2024

Perinatal Outcomes Associated With Metformin Use During Pregnancy in Women With Pregestational Type 2 Diabetes Mellitus.

Jennifer J Yland, Krista F Huybrechts, Amelia K Wesselink, Loreen Straub, Yu-Han Chiu, Ellen W Seely, Elisabetta Patorno, Brian T Bateman, Helen Mogun, Lauren A Wise and 1 more

Abstract read
In one paragraph

Article in Diabetes care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jennifer J YlandDepartment of Epidemiology, Boston University School of Public Health, Boston, MA.ORCID 0000-0001-7870-8971
Krista F HuybrechtsDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Amelia K WesselinkDepartment of Epidemiology, Boston University School of Public Health, Boston, MA.
Loreen StraubDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Yu-Han ChiuDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Ellen W SeelyEndocrinology, Diabetes and Hypertension Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Elisabetta PatornoDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.ORCID 0000-0002-8809-9898
Brian T BatemanStanford University School of Medicine, Stanford, CA.
Helen MogunDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Lauren A WiseDepartment of Epidemiology, Boston University School of Public Health, Boston, MA.
Sonia Hernández-DíazDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.

Funding

RESEARCH TRAINING IN PEDIATRIC EMERGENCY MEDICINET32HD040128 · CHILDREN'S HOSPITAL BOSTON · 2001 to 2025
$1.5M
Impact of obesity treatments on subsequent pregnancy outcomesR01HD097778 · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2025 to 2025
$659k
Novel Approaches to Monitor the Safety and Effectiveness of Newly Marketed Diabetes Medications in Older Adults Considering Frailty and MultimorbidityK08AG055670 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI Elisabetta Patorno · 2021 to 2021
$165k
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentFDA HHS U01 FD007213NIA NIH HHS K08 AG055670NICHD NIH HHS R01 HD097778NICHD NIH HHS T32 HD040128
6 · The paper itself

Abstract

objectiveWe emulated a modified randomized trial (Metformin in Women With Type 2 Diabetes in Pregnancy [MiTy]) to compare the perinatal outcomes in women continuing versus discontinuing metformin during pregnancy among those with type 2 diabetes treated with metformin plus insulin before pregnancy. RESEARCH DESIGN AND

methodsThis study used two health care claims databases (U.S., 2000-2020). Pregnant women age 18-45 years with type 2 diabetes who were treated with metformin plus insulin at conception were eligible. The primary outcome was a composite of preterm birth, birth injury, neonatal respiratory distress, neonatal hypoglycemia, and neonatal intensive care unit admission. Secondary outcomes included the components of the primary composite outcome, gestational hypertension, preeclampsia, maternal hypoglycemia, cesarean delivery, infants large for gestational age, infants small for gestational age (SGA), sepsis, and hyperbilirubinemia. We adjusted for potential baseline confounders, including demographic characteristics, comorbidities, and proxies for diabetes progression.

resultsOf 2,983 eligible patients, 72% discontinued use of metformin during pregnancy. The average age at conception was 32 years, and the prevalence of several comorbidities was higher among continuers. The risk of the composite outcome was 46% for continuers and 48% for discontinuers. The adjusted risk ratio was 0.92 (95% CI 0.81, 1.03). Risks were similar between treatments and consistent between databases for most secondary outcomes, except for SGA, which was elevated in continuers only in the commercially insured population.

conclusionsOur findings were consistent with those reported in the MiTy randomized trial. Continuing metformin during pregnancy was not associated with increased risk of a neonatal composite adverse outcome. However, a possible metformin-associated risk of SGA warrants further consideration.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsMetforminPregnancy OutcomeAdolescentAdultFemaleHumansInfant, NewbornMiddle AgedPregnancyPregnancy in DiabeticsYoung AdultHypoglycemic AgentsMetformin

Identifiers

PMID39042587
PMCPMC11362109

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.