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Metformin May Prolong Gestation in Women With Preterm Preeclampsia

No difference seen in circulating concentrations of soluble fms-like tyrosine kinase-1, placental growth factor, soluble endoglin

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THURSDAY, Sept. 23, 2021 (HealthDay News) -- Metformin seems to prolong gestation among women with preterm preeclampsia, according to a study published online Sept. 22 in The BMJ.

Catherine A. Cluver, M.D., Ph.D., from Tygerberg Hospital in Cape Town, South Africa, and colleagues randomly assigned 180 women with preterm preeclampsia between 26+0 and 31+6 weeks of gestation undergoing expectant management to receive extended-release metformin or placebo (90 to each).

The researchers found that the median time from randomization to delivery was 17.7 and 10.1 days in the metformin and placebo arms, respectively (median difference, 7.6 days; geometric mean ratio, 1.39; 95 percent confidence interval, 0.99 to 1.95; P = 0.057). The median prolongation of gestation was 17.5 days in the metformin arm compared with 7.9 days in the placebo arm among those who continued to take the trial drug at any dose (median difference, 9.6 days; geometric mean ratio, 1.67; 95 percent confidence interval, 1.16 to 2.42). The median prolongation of gestation was 16.3 and 4.8 days in the metformin and placebo arms, respectively, among those who took the full dosage (median difference, 11.5 days; geometric mean ratio, 1.85; 95 percent confidence interval, 1.14 to 2.88). No difference was seen in composite maternal, fetal, and neonatal outcomes or in circulating concentrations of soluble fms-like tyrosine kinase-1, placental growth factor, and soluble endoglin.

"This finding suggests that metformin prolongs gestation and potentially ameliorates the underlying disease through mechanisms that do not involve a reduction in the secretion of anti-angiogenic factors," the authors write.

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