Antenatal betamethasone remains essential for reducing complications of prematurity but is frequently accompanied by maternal hyperglycemia and subsequent neonatal hypoglycemia. In this multicenter, open-label randomized clinical trial involving 169 non-diabetic pregnant women at risk of preterm delivery, short-term metformin therapy initiated after betamethasone administration significantly i mproved maternal glycemic control and reduced neonatal hypoglycemia compared with standard care. Women receiving metformin demonstrated lower mean total and postprandial glucose levels within 48 hours of steroid exposure, and their preterm neonates experienced nearly a 50% reduction in hypoglycemia incidence .
Adverse effects were mild and predominantly gastrointestinal. These findings support metformin as a safe, effective, and practical strategy to counter betamethasone-induced metabolic…
