{
    "abstract": "Metformin is considered as first-line treatment for type 2 diabetes and an effective treatment for polycystic ovary syndrome (PCOS). However, evidence regarding its safety in pregnancy is limited. We conducted a systematic review and meta-analysis of major congenital malformations (MCMs) risk after first-trimester exposure to metformin in women with PCOS and pregestational diabetes mellitus (PGDM). Randomized controlled trials (RCTs) and observational cohort studies with a control group investigating risk of MCM after first-trimester pregnancy exposure to metformin were searched until December 2021. ORs and 95% CIs were calculated separately according to indications and study type using Mantel-Haenszel method; outcome data were combined using random-effects model. Eleven studies (two RCTs; nine observational cohorts) met the inclusion criteria: four included pregnant women with PCOS, four included those with PGDM and three evaluated both indications separately and were considered in both indication groups. In PCOS group, there were two RCTs (57 exposed, 52 control infants) and five observational studies (472 exposed, 1892 control infants); point estimates for MCM rates in RCTs and observational studies were OR 0.93 (95% CI 0.09 to 9.21) (I",
    "authors": [
        {
            "affiliation": "Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland nazanin.abolhassani@biham.unibe.ch.\nDepartment of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisant\u00e9), University of Lausanne, Lausanne, Vaud, Switzerland.",
            "firstname": "Nazanin",
            "initials": "N",
            "lastname": "Abolhassani"
        },
        {
            "affiliation": "Service de Pharmacologie Clinique, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Lausanne, Vaud, Switzerland.",
            "firstname": "Ursula",
            "initials": "U",
            "lastname": "Winterfeld"
        },
        {
            "affiliation": "Izmir University of Economics, School of Medicine, Izmir University of Economics, Izmir, Turkey.",
            "firstname": "Yusuf C",
            "initials": "YC",
            "lastname": "Kaplan"
        },
        {
            "affiliation": "Lausanne University Hospital and University of Lausanne, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.",
            "firstname": "C\u00e9cile",
            "initials": "C",
            "lastname": "Jaques"
        },
        {
            "affiliation": "Public Health & Primary Care Library, University Library of Bern, University of Bern, University of Bern, Bern, Switzerland.",
            "firstname": "Beatrice",
            "initials": "B",
            "lastname": "Minder Wyssmann"
        },
        {
            "affiliation": "Institute of Primary Health Care (BIHAM), University of Bern, University of Bern, Bern, Switzerland.",
            "firstname": "Cinzia",
            "initials": "C",
            "lastname": "Del Giovane"
        },
        {
            "affiliation": "Primary Care Pharmacy, Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland, University of Bern, Bern, Switzerland.\nMaterno-fetal and Obstetrics Research Unit, Department \"Femme-M\u00e8re-Enfant\", University Hospital, Lausanne, Switzerland, University of Lausanne, Lausanne, Switzerland.",
            "firstname": "Alice",
            "initials": "A",
            "lastname": "Panchaud"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
    "doi": "10.1136/bmjdrc-2022-002919\n10.1210/endrev/bnaa023\n10.1007/s00125-006-0141-7\n10.1016/j.cmet.2014.09.018\n10.1007/s00125-017-4336-x\n10.2337/dc12-0413\n10.2337/dci15-0013\n10.1016/j.diabres.2012.09.031\n10.1111/bcp.12672\n10.1056/NEJMoa0707193\n10.1097/AOG.0b013e318190a459\n10.1136/archdischild-2015-309602\n10.1371/journal.pone.0064585\n10.1007/s00404-014-3566-0\n10.1016/j.tem.2004.09.005\n10.1016/j.diabres.2013.12.056\n10.4103/jhrs.JHRS_95_18\n10.1371/journal.pone.0125712\n10.1155/2015/325851\n10.1007/s00592-014-0570-6\n10.1111/dom.12893\n10.1002/tera.1420490405\n10.1016/j.fertnstert.2006.02.098\n10.1093/humupd/dmu022\n10.1080/14767058.2019.1670804\n10.1080/14767058.2016.1228061\n10.1016/j.reprotox.2018.07.004\n10.1136/bmj.k2477\n10.1016/j.reprotox.2018.05.007\n10.1016/j.diabres.2018.01.002\n10.1186/s12884-016-0954-4\n10.1111/bcp.13481\n10.1371/journal.pmed.1000097\n10.1001/jama.283.15.2008\n10.1002/9781119536604\n10.1136/bmj.327.7414.557\n10.1210/jc.2005-0110\n10.1136/bmj.38867.631551.55\n10.1111/j.1464-5491.1994.tb00308.x\n10.1210/jcem.87.2.8207\n10.1016/j.mefs.2011.04.002\n10.1089/dia.2019.0241\n10.1186/s12884-020-03207-0\n10.1136/bmj.333.7568.597\n10.1016/j.whi.2012.10.003\n10.2337/dc07-s220\n10.1007/s11892-011-0251-6\n10.1046/j.1464-5491.2003.01017.x\n10.1007/s00125-012-2455-y\n10.1093/humupd/dmt006\n10.1016/j.ecl.2011.08.005",
    "journal": "BMJ open diabetes research & care",
    "keywords": [
        "Metformin",
        "Polycystic Ovary Syndrome",
        "Pregnancy",
        "Type 2 Diabetes"
    ],
    "methods": null,
    "publication_date": "2023-02-01",
    "pubmed_id": "36720508\n32897388\n16477438\n25456737\n28770321\n22517736\n26798149\n23068960\n25950069\n25925501\n18463376\n19104375\n26912348\n23724063\n25547060\n15519889\n24768511\n33627974\n25945500\n25874236\n24633859\n28127850\n13778533\n8073364\n16879826\n24861556\n31558075\n27549367\n30017588\n29941493\n29857030\n29325773\n29082364\n27435163\n29215149\n19621072\n10789670\n0\n12958120\n15840746\n16769748\n6369573\n8088125\n11836280\n31621408\n32887578\n16974018\n23312713\n17596476\n22167469\n12925053\n22314812\n23449641\n22108277",
    "results": null,
    "title": "Major malformations risk following early pregnancy exposure to metformin: a systematic review and meta-analysis.",
    "xml": "<Element 'PubmedArticle' at 0x788503f33290>"
}