Healthcare (Commonwealth Union) – Preterm births are a major global concern, as a significant number of births across the world occur this way.
A recent study led by the Monash University in Australia, has found that a widely used diabetes drug may lower the likelihood of early and preterm births among pregnant women with a high risk of metabolic complications.
The study, published in the New England Journal of Medicine Evidence, examined whether metformin—a low-cost oral prescription medicine commonly used to control blood glucose—could help prevent gestational diabetes and other pregnancy complications, including premature birth.
Gestational diabetes occurs when blood sugar levels become elevated during pregnancy and currently affects about one in five pregnant women in Australia. In more serious cases, the condition can increase the risk of labour occurring prematurely.
Although researchers are continuing to investigate the long-term effects of metformin use during pregnancy, the study found that the medication did not prevent gestational diabetes overall. However, it appeared to provide an important protective effect by reducing the risk of early and preterm delivery.
Preterm birth, defined as giving birth before 37 weeks of pregnancy, continues to be a major contributor to illness and death among mothers and newborns. In Australia, over 26,000 babies—approximately 8 per cent of all births—are born prematurely each year. These infants face an increased risk of breathing difficulties, developmental problems and extended periods of care in neonatal intensive care units.
Lead author Associate Professor Aya Mousa, Head of Diabetes, Metabolic and Reproductive Health Research at the Monash Centre for Health Research & Implementation, said the study found that women who took metformin had a 35 per cent lower likelihood of delivering before 37 weeks compared with women given a placebo.
Associate Professor Mousa indicated that Metformin improves the body’s ability to use insulin, which helps reduce blood glucose levels.
She further indicated that they noted that women taking metformin had less births before 37 weeks and this consisted of halving the rate of births prior to 34 weeks – down to 2.2 per cent, when contrasted with 4.4% in the placebo group.
“Among those who did deliver prematurely, pregnancy was prolonged by an average of 11 days for women on metformin.”
Researchers examined individual-level data from seven randomised, placebo-controlled clinical trials involving 2,297 pregnancies among women considered to have a high risk of metabolic complications. Participants included women with higher body weight, insulin resistance, or polyendocrine metabolic ovarian syndrome (PMOS), formerly referred to as polycystic ovary syndrome (PCOS).
Associate Professor Mousa said the potential link between metformin and a lower risk of preterm birth deserved closer examination.
Associate Professor Mousa pointed out that these results need to be validated through clinical trials specifically focused on preterm birth, including research into the most appropriate time to begin metformin treatment.
She indicated that nevertheless, the findings highlight a potentially important benefit that should be investigated further.
The research was conducted as part of the Metformin in Pregnancy Study (MiPS), a major international research collaboration led by Monash researchers. The initiative combines individual participant data from randomised clinical trials involving thousands of pregnant women to assess the effects and potential benefits of metformin during pregnancy.
Senior author Professor Helena Teede, Director of the Monash Centre for Health Research & Implementation and an endocrinologist at Monash Health, said the international research partnership had helped close a significant gap in evidence regarding the use of metformin during pregnancy. She added that the valuable dataset is now being used to investigate several additional research questions.
Professor Teede indicated that previous individual studies have reported inconsistent results and have generally been too small to provide conclusive evidence about metformin’s effects, including its potential to prevent gestational diabetes.
