Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/118460
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dc.contributor.authorMaple-Brown, L.en
dc.contributor.authorLindenmayer, G.en
dc.contributor.authorBarzi, F.en
dc.contributor.authorWhitbread, C.en
dc.contributor.authorConnors, C.en
dc.contributor.authorMoore, E.en
dc.contributor.authorBoyle, J.en
dc.contributor.authorKirkwood, M.en
dc.contributor.authorLee, I.en
dc.contributor.authorLongmore, D.en
dc.contributor.authorvan Dokkum, P.en
dc.contributor.authorWicks, M.en
dc.contributor.authorDowden, M.en
dc.contributor.authorInglis, C.en
dc.contributor.authorCotter, M.en
dc.contributor.authorKirkham, R.en
dc.contributor.authorCorpus, S.en
dc.contributor.authorChitturi, S.en
dc.contributor.authorThomas, S.en
dc.contributor.authorO'Dea, K.en
dc.contributor.authoret al.en
dc.date.issued2019en
dc.identifier.citationJournal of Diabetes, 2019; 11(9):1-10en
dc.identifier.issn1753-0393en
dc.identifier.issn1753-0407en
dc.identifier.urihttp://hdl.handle.net/2440/118460-
dc.description.abstractBACKGROUND:In Australia's Northern Territory, Indigenous mothers account for 33% of births and have high rates of hyperglycemia in pregnancy. The prevalence of type 2 diabetes (T2D) in pregnancy is up to 10-fold higher in Indigenous than non-Indigenous Australian mothers, and the use of metformin is common. We assessed birth outcomes in relation to metformin use during pregnancy from a clinical register. METHODS:The study included women with gestational diabetes (GDM), newly diagnosed diabetes in pregnancy (DIP), or pre-existing T2D from 2012 to 2016. Data were analyzed for metformin use in the third trimester. Regression models were adjusted for maternal age, body mass index, parity, and insulin use. RESULTS:Of 1649 pregnancies, 814 (49.4%) were to Indigenous women, of whom 234 (28.7%) had T2D (vs 4.6% non-Indigenous women; P < 0.001). Metformin use was high in Indigenous women (84%-90% T2D, 42%-48% GDM/DIP) and increased over time in non-Indigenous women (43%-100% T2D, 14%-35% GDM/DIP). Among Indigenous women with GDM/DIP, there were no significant differences between groups with and without metformin in cesarean section (51% vs 39%; adjusted odds ratio [aOR] 1.25, 95% confidence interval [CI] 0.87-1.81), large for gestational age (24% vs 13%; aOR 1.5, 95% CI 0.9-2.5), or serious neonatal adverse events (9.4% vs 5.9%; aOR 1.32, 95% CI 0.68-2.57). Metformin use was independently associated with earlier gestational age (37.7 vs 38.5 weeks), but the risk did not remain independently higher after exclusion of women managed with medical nutrition therapy alone, and the increase in births <37 weeks was not significant on multivariate analysis. CONCLUSIONS:We found no clear evidence of any adverse outcomes related to the use of metformin for the treatment of hyperglycemia in pregnancy.en
dc.description.statementofresponsibilityLouise J. Maple‐Brown, Greta Lindenmayer, Federica Barzi, Cherie Whitbread, Christine Connors ... Alex Brown ... et al.en
dc.language.isoenen
dc.publisherWileyen
dc.rights© 2019 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.en
dc.subjectBirth outcomes; diabetes in pregnancy; gestational diabetes; metformin; type 2 diabetes in pregnancyen
dc.titleReal-world experience of metformin use in pregnancy: observational data from the Northern Territory Diabetes in Pregnancy Clinical Registeren
dc.typeJournal articleen
dc.identifier.rmid0030109770en
dc.identifier.doi10.1111/1753-0407.12905en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1032116en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/631947en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1092968en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1078477en
dc.identifier.pubid461872-
pubs.library.collectionObstetrics and Gynaecology publicationsen
pubs.library.teamDS10en
pubs.verification-statusVerifieden
pubs.publication-statusPublisheden
dc.identifier.orcidBrown, A. [0000-0003-2112-3918]en
Appears in Collections:Obstetrics and Gynaecology publications

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