Metformin Treatment of Pregnant Women With Polycystic Ovary Syndrome: a Pilot Study (pilPregMet)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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-
-
Trondheim, Norway
- Departments of Obstetrics and Gynecology and Endocrinology, St. Olav's Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- diagnosis polycystic ovary syndrome (PCOS ) before pregnancy
- BMI 27-40 kg/m2
- Human chorionic gonadotropin, beta subunit (HCG-beta) verified pregnancy week 5-8
- At least one of the following criteria: (1) serum testosteron > 2,5 nmol/L; (2) Sex hormone binding globulin (SHBG) < 30 nmol; (3) Fasting C-peptid > 1,0 nmol/L; (4) Menstrual disturbances: oligo-/amenorrhea or metrorrhagia; (5) Hirsutism
Exclusion Criteria:
- known liver disease or ALAT > 60 IU/L
- S-creatinin > 130 micromol/L
- diabetes mellitus
- alcohol or drug abuse
- peroral steroid treatment (except inhalation steroids)
- use of cimetidine, anticoagulant, erythromycin or other macrolides
- not suitable for other reasons
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Metformin
Metformin 850 mg x 2 daily
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Metformin 850 mg x 1 per day for the first week, and 850 mg x 2 per day for the rest of the study period.. Orally.
From inclusion (before gestational week 8) to delivery.
Verbal and written diet and lifestyle advices at inclusion to the study.
In addition 1 mg tablet of folate and one daily multivitamin tablet.
Other Names:
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Placebo Comparator: placebo
Placebo 1 tablet x 2 daily
|
Placebo, 2 tablets x 1 daily for the first week, and 2 tablets x 2 for the rest of the study period.Orally.
From inclusion (that is before gestational week 12) to delivery.
Verbal and written diet and lifestyle advices at inclusion to the study.
In addition 1 mg tablet of folate and one daily multivitamin tablet.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dehydroepiandrosterone sulfate (DHEAS)
Time Frame: up to delivery
|
(µmol/l) Analysed in serum, from venous blood samples from the mother and venous and arterial umbilical cord blood (separately) collected within 1 h of birth.
Measured using a competitive immunoassay on an Immulite 2000 analyser using the reagents and calibrators supplied by the manufacturer (Diagnostic Products Corp., USA)
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up to delivery
|
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Androstenedione
Time Frame: up to delivery
|
Analysed in serum, from venous blood samples from the mother and venous and arterial umbilical cord blood (separately) collected within 1 h of birth.
measured by a double antibody technique on an Elecsys 2010 analyser (Roche Diagnostics GmbH, Germany) using reagents and calibrators supplied by the manufacturer
|
up to delivery
|
|
Testosterone
Time Frame: up to delivery
|
Analysed in serum, from venous blood samples from the mother and venous and arterial umbilical cord blood (separately) collected within 1 h of birth.
measured by a double antibody technique on an Elecsys 2010 analyser (Roche Diagnostics GmbH, Germany) using reagents and calibrators supplied by the manufacturer
|
up to delivery
|
|
Sex hormone binding globulin (SHBG)
Time Frame: up to delivery
|
(nmol/l) Analysed in serum, from venous blood samples from the mother and venous and arterial umbilical cord blood (separately) collected within 1 h of birth.
Measured using a competitive immunoassay on an Immulite 2000 analyser using the reagents and calibrators supplied by the manufacturer (Diagnostic Products Corp., USA)
|
up to delivery
|
|
Free testosterone index
Time Frame: up to delivery
|
Calculated as total testosterone divided by SHBG and multiplied by a factor of 100.
SHBG measured using a competitive immunoassay on an Immulite 2000 analyser using the reagents and calibrators supplied by the manufacturer (Diagnostic Products Corp., USA)
|
up to delivery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Occurence of pregnancy complications
Time Frame: up to 6 weeks post partum
|
Gestational diabetes (GDM) defined according to World Health Organization (1998) criteria, i.e. 2 h plasma glucose values ≥7.8 mmol/l during an Oral Glucose Tolerance Test (OGTT) with 75 g.
Uncomplicated GDM treated with dietary advice only was not ranked among the complications in this study.
Pre-eclampsia defined as a blood pressure ≥140/90mmHg with concomitant albuminuria ≥0.3 g/24 h measured on two separate occasions after gestational week 20.
Premature delivery was defined as delivery before gestational week 37 + 0 according to an estimated date of delivery, based on mid-trimester ultrasound scan
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up to 6 weeks post partum
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Pregnancy outcome - gestational age
Time Frame: after delivery
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Gestational age at birth (days)
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after delivery
|
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Pregnancy outcome - gestational length
Time Frame: after delivery
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Gestational length (cm) measured at birth
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after delivery
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Pregnancy outcome - head circumference
Time Frame: after delivery
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Head circumference (cm) measured at birth.
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after delivery
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Pregnancy outcome - birthweight
Time Frame: after delivery
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Birthweight (g) measured at birth
|
after delivery
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Pregnancy outcome - placental weight
Time Frame: after delivery
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Placental weight (g) measured at birth
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after delivery
|
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Pregnancy outcome - Agpar score at 5 minutes
Time Frame: after delivery
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Apgar score at 5 minutes
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after delivery
|
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Pregnancy outcome - Agpar score at 10 minutes
Time Frame: after delivery
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Apgar score at 10 minutes
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after delivery
|
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Pregnancy outcome - umbilical artery pH
Time Frame: after delivery
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Umbilical artery pH measured in umbilical artery blood, immediately after delivery on a Rapidlab 248pH/Blood Gas Analyzer, using reagents and calibrators supplied by the manufacturer (Bayer Corp., USA)
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after delivery
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Sven M Carlsen, MD, PhD, Norwegian University of Science and Technology
Publications and helpful links
General Publications
- Hanem LGE, Stridsklev S, Juliusson PB, Salvesen O, Roelants M, Carlsen SM, Odegard R, Vanky E. Metformin Use in PCOS Pregnancies Increases the Risk of Offspring Overweight at 4 Years of Age: Follow-Up of Two RCTs. J Clin Endocrinol Metab. 2018 Apr 1;103(4):1612-1621. doi: 10.1210/jc.2017-02419.
- Trouva A, Alvarsson M, Calissendorff J, Asvold BO, Vanky E, Hirschberg AL. Thyroid Status During Pregnancy in Women With Polycystic Ovary Syndrome and the Effect of Metformin. Front Endocrinol (Lausanne). 2022 Feb 21;13:772801. doi: 10.3389/fendo.2022.772801. eCollection 2022.
- Underdal MO, Salvesen O, Henriksen AH, Andersen M, Vanky E. Impaired Respiratory Function in Women With PCOS Compared With Matched Controls From a Population-Based Study. J Clin Endocrinol Metab. 2020 Jan 1;105(1):dgz053. doi: 10.1210/clinem/dgz053.
- Vanky E, Salvesen KA, Heimstad R, Fougner KJ, Romundstad P, Carlsen SM. Metformin reduces pregnancy complications without affecting androgen levels in pregnant polycystic ovary syndrome women: results of a randomized study. Hum Reprod. 2004 Aug;19(8):1734-40. doi: 10.1093/humrep/deh347. Epub 2004 Jun 3.
- Underdal MO, Stridsklev S, Oppen IH, Hogetveit K, Andersen MS, Vanky E. Does Metformin Treatment During Pregnancy Modify the Future Metabolic Profile in Women With PCOS? J Clin Endocrinol Metab. 2018 Jun 1;103(6):2408-2413. doi: 10.1210/jc.2018-00485.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 220800
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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