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Table 1 Summary of studies assessing GDM prevalence in women PCOS and controls with or without metformin therapy

From: Metformin therapy before conception versus throughout the pregnancy and risk of gestational diabetes mellitus in women with polycystic ovary syndrome: a systemic review, meta-analysis and meta-regression

Author, year PCOS criteria Time screening, Guideline Group 1 characteristics (PCOS patient with metformin therapy in pregnancy) Group 2 characteristics (PCOS patient without metformin therapy in pregnancy) Group 3: characteristics (Non-PCOS pregnant group) Metformin therapy in PCOS Prevalence of GDM (%)
Abd El Hameed et al. (2011)1 Rotterdam Time: 8,24,36 w, guideline: NM° N = 31, Age: 30.2 (3.8), BMI: 29.22 (2.3) N = 26, Age: 28.1 (4.3), BMI: 28.3 (1.9) Group 1: before conception till the end of pregnancy
Group 2: –
2ed trimester
Group 1: 3.2
Group 2: 23.08
Begum et al. (2009)1 Rotterdam Time: NM guideline: NM N = 29, Age: 28.1 (2.9), BMI: 28.2 (2.3) N = 30, Age: 26.1 (3.6), BMI: 27.9 (2.4) Group 1: before conception till the end of pregnancy
Group 2: before conception
Group 1: 3.44
Group 2: 30
Ashrafi et al. (2014)2 Rotterdam Time: 24–28 w, guideline: ADA N = 234, Age: 29.6 (3.9), BMI: (26.1) Group 3a: non-PCOS, infertile
N = 234, Age: 30.7 (4.7), BMI: 25.5 (4.2)
Group 3b: non-PCOS, fertile
N = 234, Age: 26.4 (5.5), BMI: 25.7 (3.8)
Group 2: before conception
Group 3: –
Group 4: –
Group 1: 44.4
Group 3a: 29.9
Group 3b: 7.3
Ashrafi et al. (2017)2 Rotterdam Time: 24–28 w, guideline: ADA Group 2a: HA + AO + PCO
N = 113, Age: 29.5 (3.8), BMI: 26.1 (3.1)
Group 2b: AO + HA
N = 5, Age: 28.6 (5.4), BMI: 27.7 (3.2)
Group 2c: HA + PCO
N = 74, Age: 29.90 (4.2), BMI: 25.94 (4.1)
Group 2d: AO + PCO
N = 16, Age: 28.3 (2.8), BMI: 25.9 (2.1)
Group 2a: no
Group 2b: no
Group 2c: no
Group 2d: no
Group 2a: 46
Group 2b: 100
Group 2c: 41.9
Group 2d: 43.8
Bjercke et al. (2002)3 NIH TIME: NM, guideline: NM Group 2 a: without IR
N = 29, Age: 31.5 (3.8), BMI: 25.2 (3.9)
Group 2 b: with IR
N = 23, Age: 31.1 (4.0), BMI: 27.7 (5.5)
N = 355, Age: 32.7 (3.4), BMI: 21.9 (2.7) Group 2a: 7
Group 2b: 9
Group 3: 0.6
D’Anna et al. (2012)3 NM Time: 24–28 w, guideline: NM N = 37, Age: 30.6 (4.2),
BMI: 24.7 (3.9)
Group 2: before conception Group 2: 54
De Fre`ne et al. (2014)3 Rotterdam Time: ~ 24 w, guideline: ADA Group 2 a: overweight
N = 93, Age: 29 (4.2), BMI: 30.8 (27.7–33.5)a
Group 2 b: Normal weight
N = 107, Age: 28.4 (3.1), BMI: 20.9 (20–22.3)a
Group 2 a: NO
Group 2 b: NO
Group 2 a: 8.2
Group 2 b: 0
De Leo et al. (2011)3 AES Time: NM, guideline: NM N = 98, Age: 32 (6), BMI: 28.3 (2.1) N = 110, Age: 33 (5), BMI: 26.6 (1.2) Group 1: before conception till 37 weeks’ gestation
Group 2:–
Group 1: 0
Group 3: 12.5
deWilde et al. (2015)3 Rotterdam Time: 24–26 w, guideline: ADA N = 72, Age: 29.6 [26.8–31.8]a, BMI: 24.4 [21.6–28.9]a Group 2: before conception Group 2: 31
deWilde et al. (2014)3 Rotterdam Time: 24–26 w, guideline: NM N = 189, Age: 29 [27–31]a, BMI: 24 [21–28]a Group 2: before conception Group 2: 22
Dmitrovic et al. (2011)2 NIH Time: 6–10, 12–16, 24–28, 34–38 w, guideline: ADA N = 17, Age: 29 (4), BMI: 32 (8) N = 17, Age: 31 (5), BMI: 26 (7) Group 2: –
Group 3: –
Group 2: 47
Group 3: 12
Elkholi et al. (2016)2 Rotterdam Time: 24–28 w, guideline: ADA Group 2a: metabolically obese
N: 62, Age: 22.3 (1.2), BMI: 21.4 (1.5)
Group 2b: metabolically healthy
N: 47, Age: 21.1 (1.6), BMI: 21.6 (1.4)
N: 35, Age: 20.4 (1.3), BMI: 21.3 (1.4) Group 2a: before conception
Group 2b: before conception
Group 3: No
Group 2a: 9.8
Group 2b: 0
Group 3: 0
Fougner et al. (2008)1 Rotterdam Time: 19, 32, 36 w, guideline: WHO N = 18, Age: 28.9 (26.5–31.4)a, BMI: 32.1 (29.1–35.2)a N: 22, Age: 28.3 (26.6–30.0)a, BMI: 29.3 (25.8–32.9)a Group 1: before conception till the end of pregnancy
Group 2: before conception
First trimester
Group 1: 11.1
Group 2: 27.2
2ed trimester
Group 1: 11.1
Group 2: 4.5
3rd trimester
Group 1: 22.2
Group 2: 9
Glueck et al. (2004)3 Rotterdam Time: 26–28 w, guideline: ADA N = 90, Age: 33 (5), BMI: 33.8 (7.8) N = 252, Age: 29 (6), BMI: 25.6 (5.9) Group 1: before conception till the end of pregnancy
Group 3: –
Group 1: 9.5
Group 3: 15.9
Glueck et al. (2004)3 Rotterdam Time: 26–28 w, guideline: ADA N = 39, Age: 30 (4), BMI: 34 (8.2) Group 1: before conception till the end of pregnancy Group 1: 7.6
Glueck et al. (2002)3 NIH Time: 26–28 w, guideline: ADA N = 33, Age: 34 (8), BMI: 33.9 Group 1: before conception till the end of pregnancy Group 1: 33
Glueck et al. (2013)3 Rotterdam Time: NM, guideline: NM N = 76, Age: 32 (5), BMI: 33.3 (7.4) N = 156, Age: 30 (6), BMI: 26.9 (6.6) Group 1: before conception till the end of pregnancy
Group 3:–
Group 1: 10.5
Group 3: 14.7
Glueck et al. (2008)3 Rotterdam Time: 26–28 w, guideline: ADA N = 142, Age: 30 (5), BMI: 33.5 (7.9) Group 1: before conception till the end of pregnancy Group 1: 7
Glueck et al. (2002)3 Rotterdam Time: 26–28 w, guideline: ADA N = 68, Age: –, BMI: 33 (29–38.8)a Group 2: before conception Group 2:
Haakova et al. (2003)3 Rotterdam Time: second, third trimester, guideline: NM N = 66, Age: 29.8 (4.9), BMI: 23.2 (3.8) N = 66, Age: 29 (4.9), BMI: 23.2 (3.8) Group 2: –
Group 3: –
Group 2: 4.92
Group 3: 12.12
Han et al. (2011)3 Rotterdam Time: 24 w, guideline: ADA Group 2a: Obese
N = 64, Age: 31.6 (3.1), BMI: 27.46 (2.4)
Group 2b: Non-obese
N = 272, Age: 31.2 (2.7), BMI: 20.45 (2.0)
Group 3a: Obese
N = 117, Age: 32.2 (3.2), BMI: 27.5 (2)
Group 3b: Non-obese
N = 886, Age: 32.5 (2.8), BMI: 20.5 (1.9)
Group 2a: no
Group 2b: no
Group 3a: no
Group 3b: no
Group 2a: 10.5
Group 2b: 1.1
Group 3a: 8.6
Group 3b: 1.8
Hassanzahraeiet al. (2007)3 NIH Time: 24–28 w, guideline: NDDG N = 47, Age: 27.8 (5.2), BMI: 25.1 (4.4) N = 100, Age: 28 (4.9), BMI: 23.4 (3.3) Group 2: –
Group 3: –
Group 2: –
Group 3: –
Joham et al. (2014)2 NM Time: NM, guideline: NM N = 478, Age: 30.5 (1.4), BMI: 28 (7.2) N = 8134, Age: 30.6 (1.5), BMI: 25.1 (5.6) Group 2: –
Group 3: –
Group 2: 11.2
Group 3: 3.8
Khattab et al. (2011)3 Rotterdam Time: 5–12, 19, 32, 36 w, guideline: WHO N = 31, Age: 30.2 (3.8), BMI: 29.22 (2.3) N = 31, Age: 30.2 (3.8), BMI: 29.22 (2.3) Group 1: before conception till the end of pregnancy
Group 2: before conception
Group 1: 4
Group 2: 20
Kollmann et al. (2015)3 1-NIH
2. Rotterdam (HA + PCO)
3. Rotterdam (OA + PCO)
Time: 24–28 w, guideline: IADPSG Group 2a: NIH criteria
N = 85, Age: 29 (26–32)a, BMI: 24.3 (21.4–29.2)a
Group 2b: Rotterdam (HA + PCO)
N = 14, Age: 31 (26–33) a, BMI: 25.5 (22.1–31.2)a
Group 2c: Rotterdam (OA + PCO)
N = 78, Age: 30 (27–33)a, BMI: 24.2 (20.5–29.7)a
N = 708,Age: 30 (25–34)a, BMI: 22.5 (20.5–25.8)a Group 2a: –
Group 2b: –
Group 2c: –
Group 2a: 18.8
Group 2b: 14.3
Group 2c: 26.9
Group 3: 2.5
Lesser et al. (1997)3 NIH Time: 20–28 w, guideline: NDDG N = 24, Age: 29.8 (5.3), BMI: 28.4 (4.7) N = 44, Age: 32 (4.6), BMI: 23.4 (2.79) Group 2: no
Group 3: no
Group 2: 16.7
Group 3: 6.7
Mehrabian et al. (2013)3 Rotterdam Time: 24–28 w, guideline: ADA Group 2a: PCOS with GDM
N = 50, Age: 34 (47.5), BMI: 28.9 (4.5)
Group 2a: PCOS without GDM
N = 130, Age: 33.3 (6.6), BMI: 25.9 (4.5)
Group 2: no Group 2 totally: 27.8
Mikola et al. (2001)3 NIH Time: NM, guideline: NM N = 99, Age: 30.4 (3.9), BMI: 25.6 (6.5) N = 737, Age: 29.4 (4.8), BMI: 23 (4.6) Group 2: no
Group 3: no
Group 2: 20
Group 3: 9
Mumm et al. (2015)3 Rotterdam Time: 14–20, 28–30 w guideline: NM N = 157, Age: 29 (26–32)a, BMI: 25.9 (22.0–32.0)a N = 995, Age: 29 (26–33)a, BMI: 23.2 (20.9–26.1)a Group 2: no
Group 3: no
Group 2: 6.4
Group 3: 13.8
Naver et al. (2014)3 Rotterdam Time: NM, guidelines: national N = 459, Age: 31.6, BMI: 22.9 N = 5409, Age: 30.7, BMI: 23.4 Group 2: no
Group 3: no
Group 2: 2.4
Group 3: 1.1
Nawaz et al. (2008)3 Rotterdam Time: 24–28 w, guideline: NM Group 1a:
N = 40, Age: 28 (3.6), BMI: 29.6 (5.1)
Group 1b:
N = 20, Age: 29 (3.1), BMI: 30 (2.6)
Group 1c:
N = 45, Age: 27 (4.2), BMI: 29.3 (3.3)
N = 32, Age: 30 (2.9), BMI: 31.2 (4.6) Group 1a: before conception till 4–16 weeks of gestation
Group 1b: before conception till 32 weeks of gestation
Group 1c: before conception till the end of pregnancy
Group 2: no
Group 1a: 37.5
Group 1b: 50
Group 1c: 28.8
Group 2: 40.6
Ott et al. (2014)3 Rotterdam Time: second trimester, guideline: NM Group 2a: conceived with LOA + metformin
N = 40, Age: 27.8 (4.9), BMI: 26.9 (5.0)
Group 2b: conceived with CC + metformin
N = 40, Age: 27.5 (4.5), BMI: 28.0 (6.0)
Group 2c: conceived with metformin only
N = 40, Age: 27.2 (4.6), BMI: (27.2 ± 5.6)
Group 2a: before conception
Group 2b: before conception
Group 2c: before conception
Group 2a: 29.4
Group 2b: 31.3
Group 2c: 31.4
Palomba et al. (2010)3 Rotterdam Time: NM, guideline: NM N = 93, Age: 30 (20–33)a, BMI: 24.2 (18.1–29.1)a N = 73, Age: 30 (19–34)a, BMI: 24 (17.8–29.4)a Group 2: no
Group 3: no
Group 2: 16.1
Group 3: 5.8
Paradisi et al. (1998)3 NIH Time: NM, guideline: NM Grou2a: PCOS with GDM
N = 5, Age: 32.2 (6.3), BMI: 28.3 (0.7)
Group 2b: PCOS without GDM
N = 8, Age: 28 (2.9), BMI: 28.3 (3.2)
Group 2: no Group 2: 38.4
Radon et al. (1999)3 ICD-9th revision Time: 24–28 w, guideline: NM N = 22, Age: 32.4 (4.1), BMI: 28.9 (8) N = 66, Age: 31.1 (3.9), BMI: 28 (7.2) Group 2: no
Group 3: no
Group 2: 40.9
Group 3: 3
Reyes-Muñoz et al. (2012)3 Rotterdam Time: 14–24 or 24–28 w, guideline: ADA N = 52, Age: 29.1 (3.9), BMI: 27.5 (3.1) N = 26, Age: 29 (3.8), BMI: 27.5 (3.3) Group 2: before conception
Group 3: –
Group 2: yes
Group 3: no
Sterling et al. (2016)3 Rotterdam criteria Time: NM, guideline: NM N = 71, Age: 33 (30–35)a, BMI: 22.7 (20.4–28.3)a N = 323, Age: 35 (32–37)a, BMI: 22.6 (20.8–26.0)a Group 2: no
Group 3: no
Group 2: 15.5
Group 3: 5
Turhan et al. (2003)3 NIH Time: 24–28 w, guideline: ADA N = 38, Age: 27.6 (3.7), BMI: 31.5 (4.5) N = 136, Age: 26.6 (4.7), BMI: 23.6 (4.3) Group 2: no
Group 3: no
Group 2: 2.6
Group 3: 8.1
Vollenhoven et al. (2000)3 NM Time: 24–28 w, guideline: WHO N = 60, Age: –, BMI: 27.1 (5.2) N = 60, Age: –, BMI: 26.5 (4.9) Group 2: no
Group 3: no
Group 2: 22
Group 3: 17
Vanky et al. (2004)1 Rotterdam Time: 19, 32, 36 w, guideline: WHO N = 18, Age: 28.9 (4.8), BMI: 32.1 (6.1) N = 22, Age: 28.3 (3.7), BMI: 29.3 (8) Group 1: before conception till the end of pregnancy
Group 2: before conception
First trimester
Group 1: 16.6
Group 2: 27.2
2ed trimester
Group 1: 11.1
Group 2: 4.5
3rd trimester
Group 1: 22.2
Group 2: 9
Vanky et al. (2010)1 Rotterdam Time: NM, guideline: NM N = 135, Age: 29.6 (4.4),
BMI: 29.5 (7)
N = 138, Age: 29.2 (4.4), BMI: 28.5 (7.2) Group 1: before conception till the end of pregnancy
Group 2: before conception
Group 1: 16.2
Group 2: 15.2
Vanky et al. (2011)2 1. NIH
2. Rotterdam
Time: 14, 28 w, guideline: WHO Group 2a: PCOS based on NIH criteria
N = 164, Age: 29.1 (4.4), BMI: 29.5 (6.62)
Group 2a: PCOS based on Rotterdam criteria
N = 93, Age: 29.6 (4.4), BMI: 27.4 (6.4)
Group 2a: no
group 2b: no
First trimester
Group 2a: 9
group 2b: 10
2ed trimester
Group 2a: 11.1
Group 2b: 4.5
3rd trimester
Group 1: 10
Group 2: 7
Veltman-Verhulst et al. (2010)3 Rotterdam Time: 24–26 w, guideline: ADA Group 2a: PCOS with GDM
N = 21, Age: 26.6 (3.5), BMI: 28.2 (5.8)
Group 2a: PCOS without GDM
N = 29, Age: 25.6 (3.0), BMI: 24.7 (5.7)
Group 2: – Group 2 totally: 42
Wan et al. (2015)3 Rotterdam Time: NM, guideline: WHO N = 25, Age: 31.4 (2), BMI: 22.8 (3.6) N = 174, Age: 32.7 (3.1), BMI: 21.5 (2.6) Group 2: no
Group 3: no
Group 2: 29.2
Group 3: 29.8
Wang et al. (2013) (120)3 Rotterdam Time: 24–28 w, guideline: ADA N = 144, Age: 30.8 (3.9), BMI: 23 (2.6) N = 594, Age: 29.1 (3.9), BMI: 20 (2.4) Group 2: no
Group 3: no
Group 2: 54.9
Group 3: 14.3
Weerakiet et al. (2004)3 NM Time: 24–28 w, guideline: ADA N = 47, Age: 31.6 (4), BMI: 24 (3) N = 264, Age: 31.3 (3.8), BMI: 22.1 (3.6) Group 2: no
Group 3: no
Group 2: 22.2
Group 3: 18
Xia et al. (2017)3 Rotterdam Time: 24–28 w, guideline: NM Group 2a: PCOS with GDM
N = 31, Age: –, BMI: 24.0 (6.4)
Group 2a: PCOS without GDM
N = 63, Age: –, BMI: 23.2 (3.0)
Group 2 totally: no Group 2 totally: 32.9
Zhang et al. (2016)2 Rotterdam Time: 24–28 w, guideline: ADA Group 2a: PCOS with GDM
N = 45, Age: 28.87 (3.20),
BMI: 24.30 (3.23)
Group 2a: PCOS without GDM
N = 223, Age: 28.06 (3.2), BMI: 23.2 (3.1)
Group 2 totally: 16.7
  1. N number, BMI body mass index, NM not mentioned, PCOS polycystic ovary syndrome, HA hyperandrogenism, AO anovulation, PCO polycystic ovary morphology, ADA American diabetes association, WHO World Health Organization
  2. aMedian (25th–75th percentile)
  3. 1Experimental study
  4. 2Cross sectional study
  5. 3Prospective study