{"id":16854,"date":"2023-10-07T11:26:34","date_gmt":"2023-10-07T15:26:34","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=16854"},"modified":"2023-10-17T11:35:48","modified_gmt":"2023-10-17T15:35:48","slug":"preconception-sglt2-or-dpp4-inhibitor-use-and-adverse-pregnancy-outcomes","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/preconception-sglt2-or-dpp4-inhibitor-use-and-adverse-pregnancy-outcomes\/","title":{"rendered":"Preconception SGLT2 or DPP4 inhibitor use and adverse pregnancy outcomes"},"content":{"rendered":"<p><strong>Aims<\/strong> \u2014 To compare preconception use of sodium-glucose cotransporter-2 (SGLT2i) and dipeptidyl peptidase-4 (DPP4i) inhibitors to sulfonylurea agents, and associated peri-conceptional A1c concentration, and risk of pregnancy loss and congenital anomalies.<\/p>\n<p><strong>Methods<\/strong> \u2014 This population-based cohort study used administrative datasets for all of Ontario, Canada, and included women eligible for free medication coverage and who achieved a recognized pregnancy from April 2007-November 2021. Exposure was a SGLT2i, DPP4i or sulfonylurea (referent) dispensed at least 90 days preconception. Study outcomes included differences in periconceptional A1c; miscarriage, induced abortion, or stillbirth; and any congenital anomaly \u2013 the latter two outcomes assessed using propensity score overlap weighting.<\/p>\n<p><strong>Results<\/strong> \u2014 The mean (SD) periconceptional A1c was 8.1 % (2.0) among those prescribed any sulfonylurea, compared with 8.3 % (2.0) with a DPP4i and 7.8 % (1.6) with any SGLT2i. The risk of pregnancy loss was lowest among those exclusively prescribed a SGLT2i (relative risk [RR] 0.51, 95 % CI 0.22 to 0.91). Risk of a congenital anomaly at birth did not differ significantly comparing DPP4i or SGLT2i to sulfonylurea agents.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Neither SGLT2i nor DPP4i use before pregnancy was associated with a difference in A1c, or a higher risk of selective adverse outcomes, compared to sulfonylureas. Future larger studies are required, including assessment of medication use after conception, during the critical period of embryogenesis.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Aims \u2014 To compare preconception use of sodium-glucose cotransporter-2 (SGLT2i) and dipeptidyl peptidase-4 (DPP4i) inhibitors to sulfonylurea agents, and associated peri-conceptional A1c concentration, and risk of pregnancy loss and congenital anomalies. Methods \u2014 This population-based cohort study used administrative datasets for all of Ontario, Canada, and included women eligible for free medication coverage and who [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[26,56],"migration-helper-qa-sample-set":[],"class_list":["post-16854","journal_article","type-journal_article","status-publish","hentry","topic-maternity-and-neonatal-care","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Ray JG, Harel Z, Gilbert RE, Wald R, Berger H, Park AL. <em>Diabetes Res Clin Pract<\/em>. 2023; 205:110946. Epub 2023 Oct 7.","source_url":"https:\/\/doi.org\/10.1016\/j.diabres.2023.110946","ices_scientist":[1338,1256,1123],"site":[6733],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Preconception SGLT2 or DPP4 inhibitor use and adverse pregnancy outcomes<\/title>\n<meta name=\"description\" content=\"Aims \u2014 To compare preconception use of sodium-glucose cotransporter-2 (SGLT2i) and dipeptidyl peptidase-4 (DPP4i) inhibitors to sulfonylurea agents, and\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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