Paternal metformin use and risk of congenital malformations in offspring in Norway and Taiwan: population based, cross national cohort study
Authors' conclusion
The findings suggest that paternal use of metformin during the period of sperm development is not associated with congenital malformations in offspring, including organ specific malformations. Metformin can therefore continue to be considered a suitable initial oral agent for managing glucose levels in men with type 2 diabetes mellitus who plan on having children.
Study context
- Population
- Offspring with paternal data during the period of sperm development; Norway 2010–21 (619,389) and Taiwan 2004–18 (2,563,812)Norway 619,389
- Exposure
- Paternal metformin use during sperm development vs no paternal metformin use
- Outcome
- Any congenital malformation
Methodological detailsoverlap propensity score weighting, sibling matched comparisons, random effects meta-analytical pooling
- Overlap propensity score weighting
- Sibling matched comparisons
- Random effects meta-analytical pooling
Main finding
As reported in the abstract
- RR of any malformation with paternal metformin use, unadjusted, Norway
- 1.29 (95% CI 1.07 to 1.55)
- RR of any malformation with paternal metformin use, unadjusted, Taiwan
- 1.08 (0.99 to 1.17)
- RR, analysis restricted to fathers with T2D, Norway
- 1.20 (0.94 to 1.53)
- RR, analysis restricted to fathers with T2D, Taiwan
- 0.93 (0.80 to 1.07)
- RR, overlap propensity score weighting restricted to fathers with T2D, Norway
- 0.98 (0.72 to 1.33)
- RR, overlap propensity score weighting restricted to fathers with T2D, Taiwan
- 0.87 (0.74 to 1.02)
- Pooled RR, overlap propensity score weighting restricted to fathers with T2D
- 0.89 (0.77 to 1.03)
Observational data: associations, not effects.
Secondary outcomes
Organ specific malformations (EUROCAT)
- No associations between paternal metformin use and any organ specific malformations
Original publication
Paternal metformin use and risk of congenital malformations in offspring in Norway and Taiwan: population based, cross national cohort study. BMJ. Published 16 October 2024. doi:10.
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