Metformin use in obese mothers tied to improved cardiovascular profile in the offspring

Takeaway

• Metformin use in obese pregnant women was associated with an improvement in the cardiovascular profile including central haemodynamics and diastolic left ventricular functional parameters in the offspring.
• No harmful effects were observed on body weight and metabolic profile.

Why this matters

• Findings suggest that the administration of metformin in obese pregnant women may offer potential cardiovascular benefits in the offspring.

Study design

• Study included 151 children from the Metformin use in Obese-Pregnant women trial, who were exposed to metformin (n=77) and placebo (n=74).
• Funding: The Fetal Medicine Foundation.

Key results

• Metformin vs placebo group showed significant reduction in:
  • aortic systolic blood pressure (MD, -0.707 [95% CI, -1.21 to -0.201] mmHg) and pulse pressure (MD, -1.65 [95% CI, -2.98 to -0.314] mmHg);
  • augmentation index (MD, -2.68%; 95% CI -5.35 to -0.01);
  • left atrial area (MD, -0.53 [95% CI, -0.84 to -0.201] cm²);
  • isovolumic relaxation time (MD, -3.2 [95% CI, -5.78 to -0.70] msec); and
  • pulmonary venous systolic wave (MD, 2.97 [95% CI, 0.94 to 5.0] cm/s; P<.05 for all).
• After adjustment for confounders, metformin vs placebo group had reduction in gluteal (mean difference [MD], -0.183; 95% CI, -0.344 to -0.022; P<.03) and tricep (MD, -0.189; 95% CI, -0.376 to -0.001; P<.05) circumference.
• No significant differences were observed in peripheral blood pressure, arterial stiffness, body composition, and metabolic profile between 2 groups.

Limitations

• Only 38.5% of children and 19.8% of blood samples were evaluated for body composition and metabolic profiles respectively.