Long-term effects of metformin use in gestational diabetes mellitus on offspring health

Table 1 Summary of the selected studies on the long-term effect of metformin on the anthropometry and metabolic parameters of the offspring

Ref.	Year	Country	Follow-up timing	Main outcomes
Rowan et al[11]	2011	Australia and New Zealand	2 yr	Metformin exposed children had (1) Larger mid-upper arm circumferences, biceps and subscapular skinfold thickness; and (2) Total fat mass and percentage body fat were similar to insulin group
Rowan et al[13]	2018	Australia and New Zealand	7 yr and 9 yr in Adelaide and Auckland cohort respectively	No difference in the metformin-exposed children and insulin-treated mothers in Adelaide cohort. In Auckland cohort: (1) Metformin-exposed children had larger weight, arm and waist circumferences, and waist: Height ratio; (2) Similar body fat percentage between two treatment groups; and (3) Visceral adipose tissue, abdominal subcutaneous adipose tissue and liver fat were similar in metformin exposed group in comparison to insulin treatment
Ijäs et al[14]	2014	Finland	mo	(1) Children exposed to metformin were significantly heavier at the age of 12 mo; and (2) Metformin exposed offspring were taller and heavier at the age of 18 mo
Landi et al[15]	2019	New Zealand	4 yr	No significant differences in weight, weight for height, or body mass index in children of insulin versus metformin exposed mothers
Paul et al[16]	2020	India	9 yr	(1) No difference in weight, body mass index, waist circumference, body fat percentages in between metformin and glibenclamide exposed children; and (2) Similar metabolic profile between two groups except mild elevation of serum triglyceride in the metformin group