Use of Metformin in Pregnancy: A Survey of Turkish Physicians' Attitudes - Original Article

Abstract
Objective: Although metformin crosses the placenta, there is no current evidence whether the use of metformin in pregnancy is associated with increased risk of fetal and maternal complications. The aim of this present study is to investigate the attitudes of Turkish physicians in different specialties in terms of metformin use in pregnancy.
Materials and Methods: Current opinions were assessed by a questionnaire. Nine hundred forty physicians were invited to join the study; however, completely fulfilled questionnaires could be obtained from a total of 407 physicians (170 family physicians, 139 internists and 98 obstetricians).
Results: One hundred fifty-one physicians (37.1%) stated that they recommended metformin use in pregnancy for any of the indications (pregnant women with PCOS, type-2 diabetes or gestational diabetes). Obstetricians were more likely to suggest metformin use in pregnancy rather than other physicians. Metformin use in pregnancy was seldom recommended by internists. The rationales of physicians for the metformin use were: lower risk for abortion, decreased prevalence of maternal and neonatal complications, improvement in insulin resistance, prevention of excess weight gain, better glycemic control in diabetics and decreased insulin need in  diabetics taking insulin.
Conclusions: Despite limited data on metformin use in pregnancy, significant number of physicians in Turkey supported the metformin use. Obstetricians were the ones most likely to recommend metformin treatment in pregnancy.