Evaluation on the use of metformin IN NON-DIABETIC obese pregnant women: Systematic review and metanalysis

Abstract Aims Can the use of metformin in non-diabetic obese pregnant women reduce maternal-fetal obstetric outcomes? Methods A systematic review of the literature was performed using the PRISMA checklist, and for bias investigation an adaptation of the Downs and Black scale was organized. Research from randomized clinical trials and nonrandomized studies between the years 2000–2020. Subsequently, a meta-analysis was developed only with randomized studies using metformin in non-diabetic obese pregnant women. For the meta-analysis, the data were extracted and analyzed using the RevMan software. Results Only 27 surveys were within the criteria established for qualitative analysis. The most recent studies using metformin have not shown significant values for maternal glycemic control. There are no side effects on the fetus with the use of metformin and, in neonatal outcomes, the drug reduces neonatal hypoglycemia and there was less admission to the intensive care unit. The interrelationship between the four randomized studies that comprised the meta-analysis showed, in the maternal results, a reduced risk for preeclampsia (RR = 0.34, 95% CI (0.20–0.56), (p = 0.000). Conclusion There is a contrast in the results with the use of metformin for gestational diabetes mellitus. The woman's preparation before pregnancy seems to be necessary to preserve her from the side effects of the drug. However current studies have been showing that metformin can be used not only in diabetic pregnant women and/or prevention of GDM, since it revealed a 66% risk reduction for preeclampsia in non-diabetic obese pregnant women.