Metformin Tied to Longer Gestation in Women With Preterm Preeclampsia

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The small study does not suggest it's time for any clinical practice changes but provides evidence that it may be possible to reduce preterm births due to preeclampsia.
Metformin extended gestation by nearly a week in women with preterm preeclampsia and was also linked to a shorter neonatal hospital stay, according to findings from a study presented January 28 at the virtual Society for Maternal–Fetal Medicine (SMFM) 2021 Annual Pregnancy Meeting.

Dr Cathy Cluver

The causes of preeclampsia have continued to elude researchers, but most agree the placenta plays a key role, explained Cathy Cluver, MBChB, PhD, director of the Preeclampsia Research Unit and an associate professor at Stellenbosch University in Cape Town, South Africa. Past trials have tested sildenafil, antithrombin, pravastatin, and esomeprazole but the drugs either did not show promise, had unacceptable side effects, or need further study.

"This trial provides proof of concept that preterm preeclampsia can be treated and that we can slow the progression of preterm preeclampsia," Cluver said.

In this trial, the researchers enrolled 180 women with preterm preeclampsia between 26 and 31 weeks gestation. All the women were taking hypertensives. They were randomly assigned to receive 3 g oral metformin XR or placebo daily. The intention-to-treat analysis included 87 women who received metformin and 84 who received placebo, with baseline characteristics similar in both groups.

Women in the metformin group gave birth a median 16.2 days after randomization, which was 6.7 days longer than the 9.5 days post-randomization delivery of women in the placebo group. The differences, however, narrowly missed statistical significance (P =.056).

But when the researchers…
Marcia Frellick
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