Are we close to a treatment for preterm preeclampsia?

Researchers of a new study published in BMJ say that extended-release metformin could prolong gestation in women with preterm preeclampsia.

According to results of the study, pregnancies were prolonged by a week in the metformin treatment group compared with the no treatment group. Authors note, however, that the results were not statistically significant and therefore point to the need for further study.

Preterm preeclampsia often leads to preterm delivery, putting infants at risk of disability and death. Preterm preeclampsia is one of the most severe variants of preeclampsia.

The trial involved 180 pregnant women undergoing monitoring for preterm preeclampsia at a large hospital in Cape Town, South Africa, between February 2018 and March 2020. Women were split into 2 arms: 90 received extended-release metformin and the other 90 received placebo. The women were 29 weeks’ pregnant on average and received either metformin or placebo until delivery.

The average time from randomization to delivery was 17.7 days in the metformin arm, and 10.1 days in the placebo arm, an average difference of 7.6 days. This difference was not statistically significant. Two more analyses were carried out, which were statistically significant, however. The first—in women who continued to take metformin at any dose—showed an average 9.6-day longer gestation, and the second—in women who took the full dose of metformin—showed an average 11.5-day longer gestation.

There were no differences between the 2 arms in terms of serious birth complications or death among both mothers and babies. No severe adverse events were observed either, although diarrhea was more common in the metformin arm.