Metformin for High-Metabolic-Risk Pregnancies: Patient-Level Meta-Analysis (NEJM Evid. 2026)

Study citation and bibliographic metadata

This PubMed record describes a meta-analysis published as: Metformin in High Metabolic Risk Pregnancies - A Patient-Level Meta-Analysis. The article appears in NEJM Evidence, 2026 Sep;5(9):EVIDoa2500337, with electronic publication date Epub 2026 Aug 25. Identifiers provided on the PubMed page include PMID 42640169 and DOI 10.1056/EVIDoa2500337.

The PubMed page included standard navigation and site information but did not include the full abstract text or study results in the supplied content. The record lists the full author group under Aya Mousa et al.

Authors and institutional affiliations

The study is authored by Aya Mousa and a large multidisciplinary international team. Institutional affiliations listed on the PubMed page include research groups and clinical departments across multiple countries. Representative institutions named on the record include:

• Monash Centre for Health Research and Implementation, Monash University, Australia
• Norwegian University of Science and Technology (NTNU) and St. Olavs Hospital, Norway
• University of Oulu and Oulu University Hospital, Finland
• University of Turku and Turku University Hospital, Finland
• National Women’s Hospital, Auckland, New Zealand
• University of Adelaide and Women’s & Children’s Hospital, Australia
• Departments of Obstetrics and Gynecology and allied clinical units in Poland, Pakistan, India, Egypt, Iran, Israel, UK and USA

This breadth of affiliations indicates a large collaborative effort spanning obstetrics, endocrinology, pharmacology and clinical research centers.

Study design and declared focus

The title explicitly identifies the work as a patient-level meta-analysis examining the use of metformin in pregnancies described as high metabolic risk. A patient-level (also called individual participant data) meta-analysis typically involves pooling de-identified participant-level data from multiple trials or cohorts to perform harmonized analyses, allow pre-specified subgroup assessments, and improve statistical power relative to aggregate-data meta-analyses. The PubMed entry confirms the study type and clinical focus but does not provide further methodological details in the supplied content.

What information is missing from the supplied source

The excerpt of the PubMed page provided here contains bibliographic metadata, author and affiliation lists, and identifiers, but does not include the abstract text, methods, results, numerical findings, adverse event profiles, statistical approach, inclusion/exclusion criteria, metformin dosing regimens, timing of exposure in pregnancy, primary or secondary endpoints, or authors’ conclusions. Therefore, any specific outcome data, effect estimates, confidence intervals, or recommendations are not available from the supplied content and must not be inferred.

Clinical relevance and possible implications

Given the title and study design, the article likely addresses clinically relevant questions about whether metformin improves maternal and/or fetal outcomes in pregnancies with elevated metabolic risk (for example, people with obesity, pregestational diabetes, gestational diabetes risk, or metabolic syndrome). A patient-level meta-analysis has the potential to:

• Evaluate treatment effects across prespecified subgroups (gestational age at treatment initiation, baseline BMI, presence of diabetes, ethnicity)
• Harmonize outcome definitions across studies
• Investigate safety signals and adverse events with greater granularity

However, because the provided PubMed content does not include results or interpretations, the clinical implications of this specific analysis cannot be determined from the supplied source alone.

Limitations due to source content

This summary is limited to the bibliographic and authorship information visible on the PubMed record excerpt. It does not contain primary data, abstract content, or full-text findings. As required by the source-based reporting policy, no study outcomes, effect sizes, or clinical recommendations have been invented or inferred. Readers should be aware that essential details required for clinical decision-making are missing from the supplied content.

How to access the full article and next steps

To evaluate the methods, numeric results, subgroup analyses, safety data, and authors’ conclusions, consult the NEJM Evidence publication (DOI 10.1056/EVIDoa2500337) or the PubMed abstract page for PMID 42640169. Accessing the full-text article will provide the complete patient-level meta-analysis methods, statistical analyses, results, and clinical interpretation necessary to inform practice or further research.

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