Obesity is on the rise in all developed countries. Of particular concern is that more young
people including children are being recognised as being overweight or obese. We know from a
recent large national enquiry into all maternal and child deaths in the UK, known as CEMACH,
that obesity is a major risk both for the mother and her child. When all deaths in women
during pregnancy are analysed, obesity comes out as the most common risk factor. Babies of
obese mothers are more than 3 times as likely to need admission to the Neonatal Intensive
Care Unit.
Traditionally, obesity is treated by lifestyle measures encouraging healthy eating and
increasing physical activity. Unfortunately these measures are often insufficient to produce
significant improvements in weight. If obese women gain little or even no weight during
pregnancy, the outcome of the pregnancy is known to be improved. This was shown in a very
large study of more than 120, 000 obese women.
The drug metformin has been used for years in the treatment of diabetes and more recently for
polycystic ovary syndrome (PCOS). Studies in pregnant PCOS women and women with diabetes in
pregnancy have shown it to be safe and effective. Fortunately it is relatively cheap and
taken as a tablet with meals.
Metformin has the great advantage of not causing weight gain and often leads to a small
amount of weight loss. It works by improving the body's sensitivity to insulin which is
important as resistance to insulin is common in obesity.
We have a lot of experience using metformin to treat women with diabetes in pregnancy where
it is greatly beneficial. We now wish to examine its potential for obese women who do not
have diabetes. We are hoping to show that it will benefit these women by causing less weight
gain, less high blood pressure, and less diabetes. We anticipate babies will also have better
birth weights, will be easier to deliver naturally, will not need to go to special care baby
units and will be healthier.
Phase:
Phase 2/Phase 3
Details
Lead Sponsor:
Epsom and St Helier University Hospitals NHS Trust
Collaborators:
Fetal Medicine Foundation King's College Hospital NHS Trust