Metformin prevents macrosomia and neonatal morbidity in gestational diabetes

Objective: to assess the clinical efficacy of metformin in the prevention of fetal macrosomia and neonatal morbidity in gestational diabetes pregnancies compared with insulin treatment. methodology: in this interventional study, randomized clinical trial a total of 150 patients with gestational diabetes between 20-35 weeks of gestation were selected for pharmacological treatment using metformin or insulin during the study period form 20-dec-2008 till 20-dec-2010 from antenatal opd after screaning with 75 grams ogtt. the primary outcomes were fetal macrosomia and neonatal morbidity. results: patients on metformin and insulin were matched in age, parity, bmi and gestational age at study entry. mean birth weight did not differ in both groups but fetal macrosomia was less in metformin group than in insulin group 18.67% v/s 10.65% p <0.05. neonatal morbidity and nicu admissions were less in metformin group. conclusion: metformin is a safe and effective alternative to insulin in gestational diabetes. metformin treatment resulted in less fetal macrosomia and fewer nicu admissions and neonatal morbidity with advantages of cheap oral therapy in our resource poor setting.