Maternal and Neonatal Outcomes in Patients of Gestational Diabetes Mellitus on Metformin Therapy

Background Present study carried out in a tertiary referral hospital in North India attempts to determine the maternal and neonatal outcomes of metformin therapy in patients of gestational diabetes mellitus. Objectives To evaluate maternal and neonatal outcomes in patients of GDM on metformin therapy and to study its adverse effects. Method In this prospective observational study, all women diagnosed with GDM not controlled by medical nutrition therapy were started on metformin therapy and the maternal and neonatal outcomes were studied. Results A total of 104 patients of GDM, not controlled on MNT and requiring pharmacotherapy, were enrolled for the study. An important clinical data from the study were that in 63.5% of patients there was no family history of diabetes mellitus. Average weight gain during pregnancy ranged from 6 to 10 kg. Glycemic control was achieved in 96.2% of patients with varying doses of metformin therapy, and it reached statistical significance. Duration of metformin therapy ranged from a minimum of 2 months to a maximum of 6 months. No serious side effects were noted except for hypoglycemia in one patient. Patient acceptability toward metformin intake was good. Mean birth weight of newborns was 2972 +/- 280 g, and no case of fetal macrosomia was seen. Neonatal hypoglycemia was seen in 3.8% of the babies and 6.7% required NICU admission. No case of congenital malformation was reported. Conclusions Metformin is a clinically effective, inexpensive and safe drug for treating gestational diabetes mellitus.