Oral hypoglycaemic agents in 118 diabetic pregnancies

Aims To assess maternal and neonatal complications in pregnancies of diabet ic women treated with oral hypoglycaemic agents during pregnancy. Methods A cohort study including all consecutively registered, orally treat ed pregnant diabetic patients set in a diabetic obstetrical service at a un iversity hospital: 50 women treated with metformin, 68 women treated with s ulphonylurea during pregnancy and a reference group of 42 diabetic women tr eated with insulin during pregnancy. Results The prevalence of pre-eclampsia was significantly increased in the group of women treated with metformin compared to women treated with sulpho nylurea or insulin (32 vs. 7 vs. 10%, P < 0.001). No difference in neonatal morbidity was observed between the orally treated and insulin-treated grou p; no cases of severe hypoglycaemia or jaundice were seen in the orally tre ated groups. However, in the group of women treated with metformin in the t hird trimester, the perinatal mortality was significantly increased compare d to women not treated with metformin (11.6 vs. 1.3%, P < 0.02). Conclusion Treatment with metformin during pregnancy was associated with in creased prevalence of pre-eclampsia and a high perinatal mortality.