Impact of Metformin and Lifestyle Interventions on Obese Pregnancies

Growing Concerns of Obesity in Pregnancy

A recent study has highlighted the effects of metformin and lifestyle guidance on the health of women and their infants during obese pregnancies. The prevalence of overweight and obese individuals has surged in recent years, raising significant concerns about the associated health risks for both mothers and infants during pregnancy.

Study Overview from the University of Adelaide

Researchers at the University of Adelaide’s Robinson Research Institute conducted a study to evaluate the necessity of dietary and lifestyle interventions in preventing complications associated with obese pregnancies. Published in The Lancet Diabetes and Endocrinology journal, the study examined birth outcomes among over 500 obese women in Australia.

The GRoW Trial Design

The trial, known as GRoW (metformin and dietary advice for Gestational Restriction of Weight in obese pregnant women), aimed to reduce the risks linked to obese pregnancies. Between May 2013 and April 2016, women were recruited from three maternity hospitals in Adelaide, South Australia. A total of 524 women were randomly assigned to the study.

Participant Criteria and Methodology

To qualify for the trial, participants needed to be pregnant with a single infant between 10 and 20 weeks of gestation and classified as overweight. Women with multiple pregnancies or pre-existing type 1 or 2 diabetes were excluded. Participants received either 500 mg of metformin, a common diabetes medication, or an identical placebo for a period of 16 weeks, followed by a 12-week supply at 28 weeks’ gestation. Of the enrolled participants, 261 received metformin while 263 received the placebo.

Monitoring and Dietary Guidance

All participants completed a questionnaire at 36 weeks of gestation to report any side effects and medication adherence. Additionally, they received dietary and lifestyle advice through face-to-face sessions, focusing on maintaining a balanced diet.

Findings of the Study

The findings indicated that women who took metformin experienced less weight gain during pregnancy and were more likely to remain within the recommended weight gain range. However, the trial faced several limitations, including a study population predominantly composed of white women from higher socioeconomic backgrounds. Furthermore, of the 3546 women eligible for the study, 85% declined to participate.

Conclusion and Future Implications

While the evidence supports the notion that combining metformin with dietary and lifestyle interventions can help reduce gestational weight gain, there was no significant effect on clinical pregnancy and birth outcomes. This study lays the groundwork for further research aimed at addressing the challenges of obese pregnancies and mitigating associated risk factors.

References

Dodd, J. (2018). Obesity intervention needed before pregnancy. The Lancet Diabetes and Endocrinology. Retrieved from https://www.eurekalert.org/pub_releases/2018-12/uoa-oin120618.php
Dodd, J.M., Louise, J. Deussen, A.R., Grivell, R.M., Dekker, G., McPhee, A.J., Hague, W. (2018). Effect of metformin in addition to dietary and lifestyle advice for pregnant women who are overweight or obese: The GRoW randomised, double-blind, placebo-controlled trial. The Lancet Diabetes and Endocrinology. Retrieved from https://doi.org/10.1016/S2213-8587(18)30310-3