Mariell Ryssdal, Johanne E. Skage, Anders H. Jarmund, Liv Guro E. Hanem, Tone S. Løvvik, Guro F. Giskeødegård, Ann-Charlotte Iversen, Eszter Vanky
{"title":"二甲双胍治疗妊娠多囊卵巢综合征可降低母体感染并增加后代过敏和湿疹的风险：两项随机对照试验和一项随访研究的事后分析","authors":"Mariell Ryssdal, Johanne E. Skage, Anders H. Jarmund, Liv Guro E. Hanem, Tone S. Løvvik, Guro F. Giskeødegård, Ann-Charlotte Iversen, Eszter Vanky","doi":"10.1111/1471-0528.18320","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To evaluate the effect of metformin on immunological outcomes in pregnant women with polycystic ovary syndrome (PCOS) and their offspring.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Post hoc analyses of two randomised controlled trials (PregMet and PregMet2) and one follow-up study (PedMet).</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Women followed at multiple hospitals in Norway, Sweden and Iceland, and offspring followed at multiple hospitals in Norway.</p>\n </section>\n \n <section>\n \n <h3> Population or Sample</h3>\n \n <p>Pregnant women with PCOS, randomised to metformin or placebo from the first trimester to delivery, and offspring exposed to metformin or placebo in utero.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Maternal infections and allergic diseases in offspring were compared using logistic regression. Maternal body mass index (BMI), offspring BMI <i>z</i>-score and maternal infections were evaluated as effect modifiers or mediators.</p>\n </section>\n \n <section>\n \n <h3> Main Outcome Measures</h3>\n \n <p>Incidence of maternal infections during pregnancy, delivery, and postpartum, and allergic diseases in offspring at 8-year follow-up.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Altogether 634 women and 145 offspring were included. Women treated with metformin experienced fewer overall infections during pregnancy (OR = 0.68, 95% CI: 0.50–0.93), particularly viral infections (OR = 0.71, 95% CI: 0.51–0.99). Offspring exposed to metformin in utero had a higher incidence of allergies (OR = 4.83, 95% CI: 1.47–21.8) and eczema (OR = 2.42, 95% CI: 1.14–5.33). Maternal BMI did not modify the effect of metformin, and offspring BMI <i>z</i>-score or maternal infections did not mediate the relationship between metformin treatment and increased allergies and eczema in offspring.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Metformin treatment in pregnant women with PCOS reduced maternal infections during pregnancy and increased the incidence of allergies and eczema in offspring at 8-year follow-up.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>ClinicalTrials.gov identifiers: NCT03259919, NCT00159536 and NCT01587378</p>\n </section>\n </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1823-1832"},"PeriodicalIF":4.3000,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18320","citationCount":"0","resultStr":"{\"title\":\"Metformin Treatment in PCOS Pregnancies Reduces Maternal Infections and Increases the Risk of Allergies and Eczema in the Offspring: Post Hoc Analyses of Two Randomised Controlled Trials and One Follow-Up Study\",\"authors\":\"Mariell Ryssdal, Johanne E. 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Maternal body mass index (BMI), offspring BMI <i>z</i>-score and maternal infections were evaluated as effect modifiers or mediators.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Main Outcome Measures</h3>\\n \\n <p>Incidence of maternal infections during pregnancy, delivery, and postpartum, and allergic diseases in offspring at 8-year follow-up.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Altogether 634 women and 145 offspring were included. Women treated with metformin experienced fewer overall infections during pregnancy (OR = 0.68, 95% CI: 0.50–0.93), particularly viral infections (OR = 0.71, 95% CI: 0.51–0.99). Offspring exposed to metformin in utero had a higher incidence of allergies (OR = 4.83, 95% CI: 1.47–21.8) and eczema (OR = 2.42, 95% CI: 1.14–5.33). 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Metformin Treatment in PCOS Pregnancies Reduces Maternal Infections and Increases the Risk of Allergies and Eczema in the Offspring: Post Hoc Analyses of Two Randomised Controlled Trials and One Follow-Up Study
Objective
To evaluate the effect of metformin on immunological outcomes in pregnant women with polycystic ovary syndrome (PCOS) and their offspring.
Design
Post hoc analyses of two randomised controlled trials (PregMet and PregMet2) and one follow-up study (PedMet).
Setting
Women followed at multiple hospitals in Norway, Sweden and Iceland, and offspring followed at multiple hospitals in Norway.
Population or Sample
Pregnant women with PCOS, randomised to metformin or placebo from the first trimester to delivery, and offspring exposed to metformin or placebo in utero.
Methods
Maternal infections and allergic diseases in offspring were compared using logistic regression. Maternal body mass index (BMI), offspring BMI z-score and maternal infections were evaluated as effect modifiers or mediators.
Main Outcome Measures
Incidence of maternal infections during pregnancy, delivery, and postpartum, and allergic diseases in offspring at 8-year follow-up.
Results
Altogether 634 women and 145 offspring were included. Women treated with metformin experienced fewer overall infections during pregnancy (OR = 0.68, 95% CI: 0.50–0.93), particularly viral infections (OR = 0.71, 95% CI: 0.51–0.99). Offspring exposed to metformin in utero had a higher incidence of allergies (OR = 4.83, 95% CI: 1.47–21.8) and eczema (OR = 2.42, 95% CI: 1.14–5.33). Maternal BMI did not modify the effect of metformin, and offspring BMI z-score or maternal infections did not mediate the relationship between metformin treatment and increased allergies and eczema in offspring.
Conclusions
Metformin treatment in pregnant women with PCOS reduced maternal infections during pregnancy and increased the incidence of allergies and eczema in offspring at 8-year follow-up.
Trial Registration
ClinicalTrials.gov identifiers: NCT03259919, NCT00159536 and NCT01587378
期刊介绍：
BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.
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