Authors caution that these results were based on
limited data (just 1 study)
Data results robust across various cohorts
Authors acknowledge study limitations
Heterogeneity in metformin dosing
Heterogeneity in diagnostic criteria for GDM
Scarcity of reporting of childhood outcomes
Metformin-exposed neonates are significantly smaller (e.g., macrosomia was 40% lower) vs insulin-exposed group
However, metformin-exposed children grow faster than insulin-exposed children
Heavier infants and higher BMI in mid-childhood
The authors point out that this pattern of low birth weight and greater postnatal ‘catch-up growth’ is associated with adverse long-term cardiometabolic outcomes (e.g., obesity, type 2 diabetes, and cardiovascular disease)
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