Progesterone, vitamins, metformin during pregnancy - ”myth” or evidence-based medicine?

M.E. Zvâncă, A. Petca, M. Boț

Rezumat: Even though pregnancy is a physiological state and delivery is a natural phenomenon, their possible complications, even rare, are severe and costly enough as to generate a perpetual quest for efficient remedies. Before becoming evidence-based medicine, most of these therapeutic or prophylactic interventions are based on simple and direct clinical observations. The purpose of this paper is to investigate the multitude of administered and self-administrated supplements during pregnancy in a search for proved benefits. Therefore, we have selected a few of the most significant obstetrical complications (preeclampsia, premature delivery, gestational diabetes, early pregnancy loss) and we have analyzed the results of different clinical trials and meta-analyses regarding the outcome of routinely recommended supplements (vitamins, calcium, omega 3 fatty acids, progesterone, metformin). Results are largely heterogeneous and are related greatly to the construction of the clinical trials, the number and selection of patients. Conclusion. Clinical judgment is recommended in most cases, but therapeutic options are widely available for an important number of obstetrical complications, and there is sufficient good quality data as to apply them in clinical practice.
Cuvinte cheie: pregnancy, prevention, metformin, progesterone, preeclampsia.