Metformin may potentially help prevent and treat preeclampsia, according to a study published in the American Journal of Obstetrics and Gynecology

Metformin has been used to treat diabetes in pregnant and non-pregnant patients for a long time. Preeclampsia has been linked to placental ischemia/hypoxia and secretion of soluble fms-like tyrosine kinase (sFlt-1) and soluble endoglin (sENG) into maternal circulation. Release of these toxins causes endothelial dysfunction and manifests as hypertension and multisystem organ injury. Currently, the only treatment for preeclampsia is delivery.  

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A team of physician-scientists from Mercy Hospital for Women and the University of Melbourne set out to determine the effects of metformin on placental sFlt-1 and sENG secretion; to investigate whether the effects of metformin on sFlt-1 and sENG secretion are regulated through the mitochondrial electron transport chain; and to examine its effects on endothelial dysfunction, maternal blood vessel vasodilation and angiogenesis.

They found that metformin lowered the production of the two toxins elevated in preeclampsia and also helped heal injured blood vessels. It also reduced endothelial cell mRNA expression of vascular cell adhesion molecule 1 induced by TNF-alpha 1. Metformin also enhanced vasodilation in omental arteries. Study authors call for future trials to investigate whether metformin can be used to treat women with preeclampsia. 

“Metformin appears to be the aspirin of the 21st century, because the drug has been discovered to have unexpected health benefits not only in diabetes, but also in polycystic ovarian disease and recent work has highlighted its anti-cancer properties,” said Dr. Roberto Romero,  Editor-in-Chief for Obstetrics of the American Journal of Obstetrics and Gynecology. He believes that “systematic reviews of previous randomized clinical trials in which pregnant women had been given metformin, as well as new randomized clinical trials, are urgently needed to determine if this simple intervention can be effective in preventing preeclampsia and other pregnancy complications.”

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