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Metformin in Pregnancy Study (MiPS): protocol for a systematic review with individual patient data meta-analysis

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dc.contributor.authorMousa, A.
dc.contributor.authorLøvvik, T.
dc.contributor.authorHilkka, I.
dc.contributor.authorCarlsen, S.M.
dc.contributor.authorMorin-Papunen, L.
dc.contributor.authorTertti, K.
dc.contributor.authorRönnemaa, T.
dc.contributor.authorSyngelaki, A.
dc.contributor.authorNicolaides, K.
dc.contributor.authorShehata, H.
dc.contributor.authorBurden, C.
dc.contributor.authorNorman, J.E.
dc.contributor.authorRowan, J.
dc.contributor.authorDodd, J.M.
dc.contributor.authorHague, W.
dc.contributor.authorVanky, E.
dc.contributor.authorTeede, H.J.
dc.date.issued2020
dc.description.abstractINTRODUCTION: Gestational diabetes mellitus (GDM) is a common disorder of pregnancy and contributes to adverse pregnancy outcomes. Metformin is often used for the prevention and management of GDM; however, its use in pregnancy continues to be debated. The Metformin in Pregnancy Study aims to use individual patient data (IPD) meta-analysis to clarify the efficacy and safety of metformin use in pregnancy and to identify relevant knowledge gaps. METHODS AND ANALYSIS: MEDLINE, EMBASE and all Evidence-Based Medicine will be systematically searched for randomised controlled trials (RCT) testing the efficacy of metformin compared with placebo, usual care or other interventions in pregnant women. Two independent reviewers will assess eligibility using prespecified criteria and will conduct data extraction and quality appraisal of eligible studies. Authors of included trials will be contacted and asked to contribute IPD. Primary outcomes include maternal glycaemic parameters and GDM, as well as neonatal hypoglycaemia, anthropometry and gestational age at delivery. Other adverse maternal, birth and neonatal outcomes will be assessed as secondary outcomes. IPD from these RCTs will be harmonised and a two-step meta-analytic approach will be used to determine the efficacy and safety of metformin in pregnancy, with a priori adjustment for covariates and subgroups to examine effect moderators of treatment outcomes. Sensitivity analyses will assess heterogeneity, risk of bias and the impact of trials which have not provided IPD. ETHICS AND DISSEMINATION: All IPD will be deidentified and studies contributing IPD will have ethical approval from their respective local ethics committees. This study will provide robust evidence regarding the efficacy and safety of metformin use in pregnancy, and may identify subgroups of patients who may benefit most from this treatment modality. Findings will be published in peer-reviewed journals and disseminated at scientific meetings, providing much needed evidence to inform clinical and public health actions in this area.
dc.description.statementofresponsibilityAya Mousa ... Janet Rowan, Jodie M Dodd, William Hague, Eszter Vanky, Helena J Teede ... et al.
dc.identifier.citationBMJ Open, 2020; 10(5):e036981-1-e036981-8
dc.identifier.doi10.1136/bmjopen-2020-036981
dc.identifier.issn2044-6055
dc.identifier.issn2044-6055
dc.identifier.orcidDodd, J.M. [0000-0002-6363-4874]
dc.identifier.orcidHague, W. [0000-0002-5355-2955]
dc.identifier.orcidTeede, H.J. [0000-0001-7609-577X]
dc.identifier.urihttp://hdl.handle.net/2440/128247
dc.language.isoen
dc.publisherBMJ
dc.relation.grantNHMRC
dc.rights© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
dc.source.urihttps://doi.org/10.1136/bmjopen-2020-036981
dc.subjectdiabetes in pregnancy
dc.subjectobstetrics
dc.subjectpreventive medicine
dc.subjectreproductive medicine
dc.titleMetformin in Pregnancy Study (MiPS): protocol for a systematic review with individual patient data meta-analysis
dc.typeJournal article
pubs.publication-statusPublished

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