Metformin use in pregnancy: promises and uncertainties.
Metformin use in pregnancy: promises and uncertainties.
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DOI：
10.1007/s00125-017-4351-y
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发表时间：
2017-09
期刊：
影响因子：
8.2
通讯作者：
Loeken MR
中科院分区：
文献类型：
--
作者：
Lindsay RS;Loeken MR
二甲双胍在怀孕期间已经被开了40多年；在这段时间的大部分时间里，使用都受到了数量和地理上的限制，证据基础仅限于观察性研究。早些年，人们对安全的担忧以及许多国家缺乏该药物的供应成为使用该药物的障碍。最近，随机对照试验已经开始检查二甲双胍在怀孕中的作用，这是急需的细节。然而，这一证据基础在不同的国家有不同的解释，导致它目前在怀孕中的应用有很大的差异。在这篇简短的综述中，我们将讨论二甲双胍在妊娠期的历史，并重点介绍一些关键的临床试验。然后，我们将考虑一些与在怀孕中使用二甲双胍有关的剩余争议，其中最重要的是由于二甲双胍能够穿过胎盘，对胎儿产生长期编程影响的可能性。我们还将考虑可以避免使用二甲双胍的临床情况。最后，我们将讨论这种药物60周年纪念日的一些未来方向。本文的在线版本(doi：10.1007/s00125-0174351-y)包含该图的幻灯片，供授权用户下载。
Metformin has been prescribed in pregnancy for over 40 years; for much of this time, use has been limited both in numbers and geographically, and the evidence base has been confined to observational studies. In early years, perceived safety concerns and lack of availability of the drug in many countries acted as a barrier to use. More recently, RCTs have begun to examine the role of metformin in pregnancy in much-needed detail. However, this evidence base has been interpreted differently in different countries, leading to very wide variation in its current application in pregnancy. In this short review, we will discuss the history of metformin in pregnancy and highlight some of the key clinical trials. We will then consider some of the remaining controversies associated with metformin use in pregnancy, most important of these being the potential for long-term ‘programming’ effects on the fetus as a result of metformin being able to cross the placenta. We will also consider clinical situations where metformin might be avoided. Finally, we will discuss some future directions for this drug as it reaches its sixtieth anniversary. The online version of this article (doi:10.1007/s00125-017-4351-y) contains a slide of the figure for download, which is available to authorised users.
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DOI：
10.1136/bmj.h102
发表时间：
2015-01-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Balsells M;García-Patterson A;Solà I;Roqué M;Gich I;Corcoy R
通讯作者：
Corcoy R
影响因子：
6
作者：
Jung, Jin Hyuk;Wang, Xiao Dan;Loeken, Mary R.
通讯作者：
Loeken, Mary R.
影响因子：
4.8
作者：
El-Mir, MY;Nogueira, V;Leverve, X
通讯作者：
Leverve, X
影响因子：
8
作者：
Lee, Hyung-yul;Wei, Dan;Loeken, Mary R.
通讯作者：
Loeken, Mary R.
影响因子：
2.5
作者：
Charles, B;Norris, R;Hague, W
通讯作者：
Hague, W