Impact of in utero metformin exposure on offspring growth and metabolic outcomes

Offspring born to women with gestational diabetes mellitus (GDM) experience long- and short-term health consequences. Metformin is an effective anti-diabetic agent that is increasingly prescribed to pregnant women for the treatment of GDM. However, metformin readily crosses the placenta into fetal circulation and concerns regarding the potential impact on fetal development have not been adequately addressed. Randomized controlled trials in humans have reported altered postnatal growth during infancy and childhood among offspring exposed to metformin in utero. However, the underlying mechanisms by which metformin exerts lasting effects on offspring remain unclear. The purpose of this study is to conduct a RCT in women with GDM to investigate the impact of either metformin or insulin treatment on infant growth. This study will also explore mechanisms of fetal mesenchymal stem cell and placental metabolism.

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