Maternal and neonatal circulating markers of metabolic and cardiovascular risk in the Metformin in Gestational diabetes (MiG) trial

Helen L. Barrett, Kathryn L. Gatford, Candice M. Houda, Miles J. De Blasio, H. David Mcintyre, Leonie K. Callaway, Marloes Dekker Nitert, Suzette Coat, Julie A. Owens, William M. Hague, Janet A. Rowan

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Abstract

OBJECTIVEdThis study was designed to compare glucose, lipids, and C-reactive protein (CRP) in women with gestational diabetesmellitus treated withmetformin or insulin and in cord plasma of their offspring and to examine how these markers relate to infant size at birth. RESEARCH DESIGN AND METHODSdWomen with gestational diabetes mellitus were randomly assigned to metformin or insulin in the Metformin in Gestational Diabetes trial. Fasting maternal plasma glucose, lipids, and CRP were measured at randomization, 36 weeks' gestation, and 6-8 weeks postpartum as well as in cord plasma. Women with available cord blood samples (metformin n = 236, insulin n = 242) were included. RESULTSdMaternal plasma triglycerides increased more from randomization to 36 weeks' gestation in women treated with metformin (21.93%) versus insulin (9.69%, P < 0.001). Maternal and cord plasma lipids, CRP, and neonatal anthropometry did not differ between treatments. In logistic regression analyses adjusted for confounders, the strongest associations with birth weight .90th centile were maternal triglycerides and measures of glucose control at 36 weeks. CONCLUSIONSdThere were few differences in circulating maternal and neonatal markers of metabolic status and no differences in measures of anthropometry between the offspring of women treated with metformin and the offspring of women treated with insulin. There may be subtle effects of metformin on maternal lipid function, but the findings suggest that treating gestational diabetes mellitus with metformin does not adversely affect lipids or CRP in cord plasma or neonatal anthropometric measures.

Original languageEnglish
Pages (from-to)529-536
Number of pages8
JournalDiabetes Care
Volume36
Issue number3
DOIs
Publication statusPublished - 1 Mar 2013
Externally publishedYes

Cite this

Barrett, H. L., Gatford, K. L., Houda, C. M., De Blasio, M. J., Mcintyre, H. D., Callaway, L. K., Nitert, M. D., Coat, S., Owens, J. A., Hague, W. M., & Rowan, J. A. (2013). Maternal and neonatal circulating markers of metabolic and cardiovascular risk in the Metformin in Gestational diabetes (MiG) trial. Diabetes Care, 36(3), 529-536. https://doi.org/10.2337/dc12-1097