Immunomodulatory Effects of Metformin Treatment in Pregnant Women With Polycystic Ovary Syndrome (PCOS)
Authors' conclusion
It appears that metformin has immunomodulating rather than anti-inflammatory properties in pregnancy. Its effect on the serum levels of many multifunctional cytokines demonstrates robust, persisting, and body mass-dependent immune mobilization in pregnant women with PCOS.
Study context
- Population
- Pregnant women with PCOS
- Participants
- 615 women2 RCTs
- Comparison
- Metformin vs placebo from first trimester to delivery
- Primary endpoint
- Maternal immunological status: 22 cytokines and C-reactive protein in serum
- Follow-up
- Gestational weeks 5 to 12, 19, 32, and 36
Methodological detailsPregMet and PregMet2, longitudinal maternal serum samples
- PregMet and PregMet2
- Longitudinal maternal serum samples
Primary result
As reported in the abstract
Serum cytokine levels · throughout pregnancy
- Metformin associated with higher serum levels of several multifunctional cytokines throughout pregnancy
- Combined cytokine development confirmed impact of metformin on half of the 22 cytokines
- Metformin vs Placebo: P < 0.001
- Metformin vs Placebo: P = 0.03
- Metformin vs Placebo: P = 0.04
- Post-hoc analysis
Further findings
Effect by BMI category
- Immunomodulating effect more potent in normal weight and overweight than in obese women
Effect by androgen status
- Normoandrogenic women: strongest effect in early pregnancy; hyperandrogenic women: increasing effect throughout pregnancy
Original publication
Immunomodulatory Effects of Metformin Treatment in Pregnant Women With PCOS. J Clin Endocrinol Metab. Published 14 March 2023. doi:10.
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