Maternal obesity during pregnancy increases the risk of complications and adverse neonatal outcome. Studies in the past have shown its link with long-lasting adverse effects in the offspring, including increased body fat mass, insulin resistance, and increased risk for premature cardiovascular disease. Lifestyle interventions in pregnancy may have none or modest impact in terms of reducing adverse pregnancy outcomes in obese mothers.¹ Furthermore, metformin has been considered a valuable drug during pregnancy due to its beneficial effects on glycemia and pregnancy outcomes.² The Metformin in Obese Pregnant Women trial was associated with decreased adverse pregnancy outcomes and had no effect on birthweight. However, long-term implications of this agent on the health of offspring remain obscure.¹

With regard to this, a study that was conducted to evaluate whether prenatal exposure to metformin can improve the cardiovascular profile and body composition in the offspring of obese mothers. In this study, body composition, peripheral blood pressure, and arterial pulse wave velocity were measured in 151 children (age: 3.9±1.0 years) from the Metformin in Obese Pregnant Women trial. Of these, 77 children had been exposed to metformin prenatally. The results revealed no significant difference in peripheral blood pressure, arterial stiffness, and body composition apart from gluteal and tricep circumferences, which were lower in the metformin group (P<.05). Moreover, compared with the placebo group, metformin group had lower central hemodynamics (mean adjusted decrease: -0.707 mm Hg for aortic systolic blood pressure, -1.65 mm Hg for aortic pulse pressure, and -2.68% for augmentation index; P<.05 for all) and lower left ventricular diastolic function (adjusted difference in left atrial area: -0.525 cm², in isovolumic relaxation time: -0.324 msec, and in pulmonary venous systolic wave: 2.97 cm/s; P<.05 for all). No significant differences were seen in metabolic profile between the groups. Based on this study, the researchers suggested that children of obese mothers who were prenatally exposed to metformin, compared to placebo, had relatively lower central hemodynamic and cardiac diastolic indices. Thus, administration of metformin in obese pregnant women may have beneficial effect on cardiovascular parametersintheir offspring.¹

References

1. Panagiotopoulou O, Syngelaki A, Georgiopoulos G, et al. Metformin use in obese mothers is associated with improved cardiovascular profile in the offspring. Am J Obstet Gynecol. 2020 Aug;223(2):246.e1-246.e10.
2. Jorquera G, Echiburú B, Crisosto N, et al. Metformin during Pregnancy: Effects on Offspring Development and Metabolic Function. Front Pharmacol. 2020;11:653.