Metformin in obese pregnancy has no adverse effects on cardiovascular risk in early childhood.
Metformin in obese pregnancy has no adverse effects on cardiovascular risk in early childhood.
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肥胖妊娠期间的二甲双胍对儿童早期的心血管风险没有不利影响。
DOI：
10.1017/s2040174421000301
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发表时间：
2022
影响因子：
1.7
通讯作者：
Yang L
中科院分区：
文献类型：
--
作者：
Yang L
尽管二甲双胍对儿童缺乏长期安全性，但仍广泛用于妊娠期。我们假设子宫内暴露二甲双胍与心血管风险增加有关。我们在一项对肥胖母亲所生的孩子进行的后续研究中检验了这一假设，这些母亲参加了妊娠期二甲双胍与安慰剂的随机对照试验 (EMPOWaR)。我们使用示波装置测量了 40 名平均 (SD) 年龄为 5.78 (0.93) 岁、在子宫内接受二甲双胍 (n = 19) 或安慰剂 (n = 21) 的儿童的身体成分、外周血压 (BP)、动脉脉搏波速度和中心血流动力学（中心血压和增强指数）。在单变量分析中，或在对包括儿童行为、饮食和活动水平在内的潜在混杂因素进行调整后，二甲双胍组和安慰剂组之间的任何人体测量或血管测量结果均没有差异。事后样本量计算表明，我们本可以检测到各组之间存在较大的临床显着差异，但需要不可行的大量数据来检测该随访年龄儿童关键心血管风险参数可能存在的细微差异。我们的研究结果表明，没有证据表明肥胖母亲在怀孕期间服用二甲双胍所生的孩子的心血管风险会增加，并增加了二甲双胍对儿童结局的长期安全性的现有知识。
Metformin is widely used in pregnancy, despite lack of long-term safety for children. We hypothesised that metformin exposure in utero is associated with increased cardiovascular risk. We tested this hypothesis in a follow-up study of children born to obese mothers who had participated in a randomised controlled trial of metformin versus placebo in pregnancy (EMPOWaR). We measured body composition, peripheral blood pressure (BP), arterial pulse wave velocity and central haemodynamics (central BP and augmentation index) using an oscillometric device in 40 children of mean (SD) age 5.78 (0.93) years, exposed to metformin (n = 19) or placebo (n = 21) in utero. There were no differences in any of the anthropometric or vascular measures between metformin and placebo-exposed groups in univariate analyses, or after adjustment for potential confounders including the child’s behaviour, diet and activity levels. Post-hoc sample size calculation indicated we would have detected large clinically significant differences between the groups but would need an unfeasible large number to detect possible subtle differences in key cardiovascular risk parameters in children at this age of follow-up. Our findings suggest no evidence of increased cardiovascular risk in children born to obese mothers who took metformin in pregnancy and increase available knowledge of the long-term safety of metformin on childhood outcomes.